John D. Uphold, MD, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

JOHN D. UPHOLD, MD, INC.

Doing business as

Beverly Emergency Medical Group, Inc.

Practice address

309 W Beverly Blvd
Montebello, CA 90640-4308

Phone

(818) 340-9988

Fax

(818) 587-2493

NPI assigned

Oct 7, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. John D Uphold, MD

Title

President

Phone

(818) 340-9988

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Beverly Emergency Medical Group, Inc. Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003804717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4419",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913654419",
            "telephone_number": "818-340-9988",
            "fax_number": "818-587-2493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 W BEVERLY BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906404308",
            "telephone_number": "818-340-9988",
            "fax_number": "818-587-2493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN D. UPHOLD, MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "UPHOLD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-340-9988",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0051100",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beverly Emergency Medical Group, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Specialist in Montebello, CA
• Providers in Montebello, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.