The Heart Shack

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

THE HEART SHACK

Practice address

9107 Wilshire Blvd
Suite 450
Beverly Hills, CA 90210-5531

Phone

(310) 623-8584

NPI assigned

Jun 30, 2011

Last updated

Jun 30, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Julia Bernard

Title

Ceo

Phone

(310) 623-8584

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309392000000",
    "number": "1336436138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9107 WILSHIRE BLVD",
            "address_2": "SUITE 450",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902105531",
            "telephone_number": "310-623-8584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9107 WILSHIRE BLVD",
            "address_2": "SUITE 450",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902105531",
            "telephone_number": "310-623-8584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE HEART SHACK",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-30",
        "last_updated": "2011-06-30",
        "status": "A",
        "authorized_official_last_name": "BERNARD",
        "authorized_official_first_name": "JULIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-623-8584",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; 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.