Dale Prokupek MD Inc

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

G71035 Issued in CA

Legal business name

DALE PROKUPEK MD INC

Practice address

8641 Wilshire Blvd
100
Beverly Hills, CA 90211-2900

Phone

(310) 360-6807

Fax

(310) 360-6683

NPI assigned

Mar 22, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Dale A Prokupek, M.D.NPI 1780725408

Title

Owner

Phone

(310) 360-6807

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

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

• Dale Alan Prokupek, MD

  • Gastroenterology Physician
  • Beverly Hills, CA
  • NPI 1780725408
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1300752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300752000000",
    "number": "1548569197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 N FAIRFAX AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900462136",
            "telephone_number": "310-360-6807",
            "fax_number": "310-360-6683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8641 WILSHIRE BLVD",
            "address_2": "100",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112900",
            "telephone_number": "310-360-6807",
            "fax_number": "310-360-6683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALE PROKUPEK MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-22",
        "last_updated": "2011-03-22",
        "status": "A",
        "authorized_official_last_name": "PROKUPEK",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-360-6807",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "G71035",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "G71035",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "G71035A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adam Alexander D'Sa, MD
• Fereidoun Daftary, DDS
• Elon Dahan
• Dahlia T Carr MD Inc
• Dale Basescu Chiropractic Inc.
• David V Daleo, PSYD
• Jill Daloria, SLP
• Madalyn Dame
• Dan Naim MD a Medical Corporation
• Dana Elise Solutions

• Gastroenterology Physician in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.