Olga Beregovskaya
Individual provider Active NPI Internal Medicine Physician · Corcoran, CA
NPI 1548469117 · NPPES record last updated Jul 13, 2007
Key facts
- NPI
- 1548469117
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- A93529 (CA)
- Practice address
- 900 Quebec Avenue
Corcoran, CA 93212 - Phone
- (559) 992-7100
- Fax
- (559) 992-7104
- NPI assigned
- Jul 13, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141203001109 | CA | Practitioner - Internal Medicine |
4284956137 | Practice locations: North Hollywood, CA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A93529 | CA | MD | Internal Medicine Physician |
Interoperability endpoints
- biomdbalancesolutions@org46.direct.charmhealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A93529 | CA | Yes |
Addresses
Primary practice location
900 Quebec Avenue
Corcoran, CA 93212
Mailing address
900 Quebec Avenue
Corcoran, CA 93212
Phone (559) 992-7100
Other providers in Corcoran, CA
- Adriana Christina Barry-Souza
- Stephen Dale Bartlett
- Jasper Fermell Basit
- Michael C Bean
- Helen Ann Becich
- Brittany Danielle Blowers
- Carolyn Virginia Bola
- Roberto Carlos Bonilla
- Harland Travis Boreen
- Jonathan Bradley
All providers in Corcoran, CA · Internal Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.