Meejung Belasco, APNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

21604 Issued in CA

Practice address

4244 Riverwalk Pkwy
Ste. 170
Riverside, CA 92505-8509

Phone

(951) 736-7432

Fax

(951) 736-7751

NPI assigned

Jul 2, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Christine Belasco Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Great Lakes Dermatology SC

  • Dermatology Physician
  • Mount Pleasant, WI
  • NPI 1851467047
  NPD (past)

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

{
    "created_epoch": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370908800000",
    "number": "1144459892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 894830",
            "address_2": "LOCK BOX 4830",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "901894830",
            "telephone_number": "702-853-7451",
            "fax_number": "909-557-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4244 RIVERWALK PKWY",
            "address_2": "STE. 170",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925058509",
            "telephone_number": "951-736-7432",
            "fax_number": "951-736-7751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELASCO",
        "first_name": "MEEJUNG",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-02",
        "last_updated": "2013-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "3750-033",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "21604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144459892",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "171400019",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "BELASCO",
            "credential": "APNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nancy Bejarano
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• Peter Bekzadian-Avila
• Bela Pro LLC
• Kendrick Belardo, MD
• Donna Lynn Belger
• David Sisak Beljaev
• Alfred Russell Bell
• Evelyn Bell
• Bella Vita Congregate Living, LLC

• Nurse Practitioner in Riverside, CA
• Providers in Riverside, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2013; 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.