Chung Medical Corporation, Inc

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

RHM53857G Issued in CA

Legal business name

CHUNG MEDICAL CORPORATION, INC

Doing business as

Beverly Medical Center, II, Inc

Practice address

1415 W Rosamond Blvd
Suite 24
Rosamond, CA 93560-7429

Phone

(661) 256-1866

Fax

(661) 256-1649

NPI assigned

Jun 1, 2006

Last updated

Nov 11, 2008By 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

Beverly Elaine Thorbus, R.N.

Title

Owner / Administrator

Phone

(760) 382-3505

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• BEVERLY MEDICAL CENTER, II, INC Doing business as

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226361600000",
    "number": "1386681187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 W ROSAMOND BLVD",
            "address_2": "SUITE 24",
            "city": "ROSAMOND",
            "state": "CA",
            "postal_code": "935607429",
            "telephone_number": "661-256-1866",
            "fax_number": "661-256-1649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 W ROSAMOND BLVD",
            "address_2": "SUITE 24",
            "city": "ROSAMOND",
            "state": "CA",
            "postal_code": "935607429",
            "telephone_number": "661-256-1866",
            "fax_number": "661-256-1649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHUNG MEDICAL CORPORATION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2008-11-11",
        "status": "A",
        "authorized_official_last_name": "THORBUS",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "OWNER / ADMINISTRATOR",
        "authorized_official_telephone_number": "760-382-3505",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "CA",
            "license": "RHM53857G",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM53857G",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HAP53857G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BEVERLY MEDICAL CENTER, II, INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nancy R Barragan
• Karim Botros
• Halima Hussein Burton, DH21516
• Alicia Lynn Cambaliza, LMFT
• Latisha Carter
• Crystal Clark
• Jasmine Cole
• Jasmin Dhillon
• Jorge Diaz
• Tanika Marie Dodd

• Rural Health Clinic/Center in Rosamond, CA
• Providers in Rosamond, CA by specialty
• Rural Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2008; 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.