NPIMap

Organization Active NPI

Patrick T. Bezdek M.D., Inc.

  • Adult Mental Health Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1174703839
Registry record updated Nov 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
G27084 Issued in CA
Legal business name
PATRICK T. BEZDEK M.D., INC.
Practice address
11980 San Vicente Blvd Ste 904
Los Angeles, CA 90049-6607
Phone
(310) 820-2995
Fax
(310) 454-2587
NPI assigned
Nov 10, 2007
Last updated
Nov 10, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2007

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

Authorized official

Name
Dr. Patrick T. Bezdek, M.D.NPI 1639157100
Title
Owner
Phone
(310) 820-2995

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X G27084 CA Primary

Addresses

Primary practice location

11980 San Vicente Blvd Ste 904
Los Angeles, CA 90049-6607

Mailing address

11980 San Vicente Blvd Ste 904
Los Angeles, CA 90049-6607
Phone (310) 820-2995

National Provider Directory

National Provider Directory

Locations

11980 San Vicente Blvd
Ste 904
Los Angeles, CA 90049
Phone (310) 820-2995

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1194652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194652800000",
    "number": "1174703839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11980 SAN VICENTE BLVD STE 904",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900496607",
            "telephone_number": "310-820-2995",
            "fax_number": "310-454-2587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11980 SAN VICENTE BLVD STE 904",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900496607",
            "telephone_number": "310-820-2995",
            "fax_number": "310-454-2587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICK T. BEZDEK M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-10",
        "last_updated": "2007-11-10",
        "status": "A",
        "authorized_official_last_name": "BEZDEK",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-820-2995",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "CA",
            "license": "G27084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2007; 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.