Beacon Community Medical Center, Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC29535 Issued in CA

Legal business name

BEACON COMMUNITY MEDICAL CENTER, INC.

Practice address

2017 W Olympic Blvd
Los Angeles, CA 90006-3705

Phone

(213) 480-1000

Fax

(213) 401-0018

NPI assigned

Apr 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. William Jonathan Park, D.C.

Title

Ceo

Phone

(213) 480-1000

Specialties & licenses 3

Addresses

Other identifiers 5

Locations

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195430400000",
    "number": "1245351808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2017 W OLYMPIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900063705",
            "telephone_number": "213-480-1000",
            "fax_number": "213-401-0018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2017 W OLYMPIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900063705",
            "telephone_number": "213-480-1000",
            "fax_number": "213-401-0018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON COMMUNITY MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2007-11-19",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "JONATHAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "213-480-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC29535",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A54010",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "20A8246",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8099936",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1962477299",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1891798674",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1821091661",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0102480",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Beach
• Maya Victoria Beach
• Tara Beach, LMFT, ATR-BC
• Christopher Scott Beachey
• Beachside Anesthesia a Professional Corporation
• Beacon Outreach Initiatives LLC
• Peter Yonger Salam Beah, MD
• Omer E Beaird, MD
• Michelle Beakey
• Chantiste Beal, D.M.D.

• Chiropractor in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.