Organization
BEVERLY INTERNAL MEDICINE MEDICAL GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SOUMITRA SARKAR M.D. (PRESIDENT)
(323) 728-0653
Entity
Organization
Contact information
Practice address
2614 W BEVERLY BLVD, MONTEBELLO, CA 90640-2310
(323) 728-0653
Mailing address
2614 W BEVERLY BLVD, MONTEBELLO, CA 90640-2310
(323) 728-0653
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A53499
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A534990
—
CA
01
—
110208996
RAILROAD MEDICARE
CA
Enumeration date
11/12/2007
Last updated
02/21/2014
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