Malibu Medical Corp

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

20A7615 Issued in CA

Legal business name

MALIBU MEDICAL CORP

Practice address

23661 Pacific Coast Hwy
Malibu, CA 90265-4825

Phone

(310) 456-1603

Fax

(310) 456-5697

NPI assigned

Nov 15, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Lisa M Benya, D.O.NPI 1972515781

Title

Owner

Phone

(310) 456-1603

Specialties & licenses 1

Addresses

Tax ID family

Malibu Medical Corp2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Malibu Medical Corporation

  • Internal Medicine Physician
  • Malibu, CA
  • NPI 1821287764
  NPD tax ID

Locations

Practitioners 1

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

• Lisa Marie Benya, D.O.

  • Internal Medicine Physician
  • Malibu, CA
  • NPI 1972515781
  NPD Authorized official

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352937600000",
    "number": "1386988590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23661 PACIFIC COAST HWY",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902654825",
            "telephone_number": "310-456-1603",
            "fax_number": "310-456-5697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23661 PACIFIC COAST HWY",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902654825",
            "telephone_number": "310-456-1603",
            "fax_number": "310-456-5697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALIBU MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A",
        "authorized_official_last_name": "BENYA",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-456-1603",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "CA",
            "license": "20A7615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Malibu Detox, LLC.
• Malibu Hills Treatment Corp
• Malibu Horizon Inc
• Malibu Lighthouse Treatment Centers (Summit Malibu)
• Malibu Lighthouse Treatment Centers (Avalon Ranch)
• Malibu Medical Corporation
• Malibu Occupational & Speech Therapy
• Malibu Outpatient Inc
• Malibu Renewal Centre
• Malibu Seaside Serenity Cove, Inc.

• Urgent Care Clinic/Center in Malibu, CA
• Providers in Malibu, CA by specialty
• Urgent Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.