Organization Active NPI

Bhava Narayanan, M.D. a Professional Medical Corporation

  • Pediatrics Physician
  • Montebello, CA
National Provider Identifier
1174610380
Registry record updated Sep 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A68048 Issued in CA
Legal business name
BHAVA NARAYANAN, M.D. A PROFESSIONAL MEDICAL CORPORATION
Practice address
101 E Beverly Blvd
Suite 306
Montebello, CA 90640-4300
Phone
(323) 888-8646
Fax
(323) 888-1553
NPI assigned
Oct 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2012

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

Authorized official

Name
Dr. Bhavadharini Narayanan, M.D.
Title
President
Phone
(323) 888-8646

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X A68048 CA Primary

Addresses

Primary practice location

101 E Beverly Blvd
Suite 306
Montebello, CA 90640-4300

Mailing address

641 S Santa Anita Ave
San Marino, CA 91108-1419
Phone (323) 888-8646

Other identifiers 1

IdentifierTypeStateIssuer
00A680480MedicaidCA

National Provider Directory

National Provider Directory

Locations

101 E Beverly Blvd
Ste 306
Montebello, CA 90640
Phone (323) 888-2323

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348444800000",
    "number": "1174610380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "641 S SANTA ANITA AVE",
            "city": "SAN MARINO",
            "state": "CA",
            "postal_code": "911081419",
            "telephone_number": "323-888-8646",
            "fax_number": "323-888-1553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E BEVERLY BLVD",
            "address_2": "SUITE 306",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906404300",
            "telephone_number": "323-888-8646",
            "fax_number": "323-888-1553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BHAVA NARAYANAN, M.D. A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-07",
        "last_updated": "2012-09-24",
        "status": "A",
        "authorized_official_last_name": "NARAYANAN",
        "authorized_official_first_name": "BHAVADHARINI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-888-8646",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A68048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A680480",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montebello, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2012; 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.