Organization
BEACON COMMUNITY MEDICAL CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM JONATHAN PARK D.C. (CEO)
(213) 480-1000
Entity
Organization
Contact information
Practice address
2017 W OLYMPIC BLVD, LOS ANGELES, CA 90006-3705
(213) 480-1000
(213) 401-0018
Mailing address
2017 W OLYMPIC BLVD, LOS ANGELES, CA 90006-3705
(213) 480-1000
(213) 401-0018
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC29535
CA
174400000X
Specialist
20A8246
CA
174400000X
Specialist
A54010
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1821091661
NPI
CA
01
—
1891798674
NPI
CA
01
—
1962477299
NPI
CA
05
—
8099936
—
CA
05
—
GR0102480
—
CA
Enumeration date
04/02/2007
Last updated
11/19/2007
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