Je Medical Corporation

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

A73998 Issued in CA

Legal business name

JE MEDICAL CORPORATION

Practice address

9461 Charleville Blvd # 242
Beverly Hills, CA 90212-3017

Phone

(310) 292-4883

Fax

(310) 861-1711

NPI assigned

Aug 5, 2014

Organization subpart

No

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

Authorized official

Name

Ali John Enayati, M.D.

Title

President/Owner

Phone

(310) 292-4883

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1407196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407196800000",
    "number": "1437568235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9461 CHARLEVILLE BLVD # 242",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902123017",
            "telephone_number": "310-292-4883",
            "fax_number": "310-861-1711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9461 CHARLEVILLE BLVD # 242",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902123017",
            "telephone_number": "310-292-4883",
            "fax_number": "310-861-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JE MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-05",
        "last_updated": "2014-08-05",
        "status": "A",
        "authorized_official_last_name": "ENAYATI",
        "authorized_official_first_name": "ALI",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "310-292-4883",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A73998",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "A73998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2014; 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.