Individual provider Active NPI

Aman Berhane, PA-C

  • Physician Assistant
  • Baldwin Park, CA
National Provider Identifier
1508193640
Registry record updated Nov 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 20619 Issued in CA
Practice address
4126 Maine Ave
Baldwin Park, CA 91706-3306
Phone
(562) 867-8681
NPI assigned
Nov 10, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 20619 CA Primary

Addresses

Primary practice location

4126 Maine Ave
Baldwin Park, CA 91706-3306

Mailing address

1000 San Gabriel Blvd Ste 200
Rosemead, CA 91770-4394
Phone (323) 724-0019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160422001295 CA Practitioner - Physician Assistant 8022235886 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
20619CAMDSpeech-Language Pathologist
PA 20619CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pih Health Physicians CurrentSince Nov 11, 2019 Accepting new patients
Bright Health Physicians of Pih CurrentSince Nov 11, 2019 Accepting new patients
Central City Community Health Center Inc General Practice CurrentSince Feb 9, 2020 Accepting new patients

Locations

4126 Maine Ave
Baldwin Park, CA 91706
Phone (626) 653-0800

10251 Artesia Blvd
Bellflower, CA 90706
Phone (562) 229-9452

10050 Garvey Ave
Ste 111
El Monte, CA 91733
Phone (626) 652-0790

12675 La Mirada Blvd
Ste 201401
La Mirada, CA 90638
Phone (562) 903-7339

13742 Amar Rd
La Puente, CA 91746
Phone (626) 652-0790

5970 S Central Ave
Los Angeles, CA 90001
Phone (213) 234-3280

2019 Saturn St
Monterey Park, CA 91755
Phone (323) 724-0019

1000 San Gabriel Blvd
Ste 200
Rosemead, CA 91770
Phone (323) 724-0019

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1257811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573776000000",
    "number": "1508193640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 SAN GABRIEL BLVD STE 200",
            "city": "ROSEMEAD",
            "state": "CA",
            "postal_code": "917704394",
            "telephone_number": "323-724-0019",
            "fax_number": "323-248-7044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4126 MAINE AVE",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917063306",
            "telephone_number": "562-867-8681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERHANE",
        "first_name": "AMAN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-10",
        "last_updated": "2019-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA 20619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baldwin Park, CA

Sources for this page

Verify at the official NPI Registry.