Organization
WEST BEVERLY MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JESSIE ANTONIO JR. (MANAGER)
(323) 461-4183
Entity
Organization
Contact information
Practice address
4643 BEVERLY BLVD, #103, LOS ANGELES, CA 90004-3101
(323) 461-4183
(323) 461-0864
Mailing address
4643 BEVERLY BLVD, #103, LOS ANGELES, CA 90004-3101
(323) 461-4183
(323) 461-0864
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
03/18/2008
Last updated
03/18/2008
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