Organization Active NPI

Sanare Sanctuary Inc

  • Neurology Physician
  • Beverly Hills, CA
National Provider Identifier
1578867586
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
SANARE SANCTUARY INC
Practice address
415 N Crescent Dr
Ste 110
Beverly Hills, CA 90210
Phone
(310) 432-2880
Fax
(310) 432-2887
NPI assigned
Jan 5, 2011
Last updated
Mar 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Authorized official

Name
Joann Pecoraro
Title
Biz MGR
Phone
(818) 307-0074

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X Primary

Addresses

Primary practice location

415 N Crescent Dr
Ste 110
Beverly Hills, CA 90210

Mailing address

415 N Crescent Dr
Ste 110
Beverly Hills, CA 90210
Phone (818) 307-0074

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240507003258 CA Part B Supplier - Clinic/Group Practice 6507235702 Receives reassigned benefits from 2 practitioners
Practice locations: Beverly Hills, CA

National Provider Directory

National Provider Directory

Locations

415 N Crescent Dr
Ste 110
Beverly Hills, CA 90210
Phone (310) 432-2880

2006 N Sepulveda Blvd
Manhattan Beach, CA 90266
Phone (310) 925-5384

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1294185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709769600000",
    "number": "1578867586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N CRESCENT DR",
            "address_2": "STE 110",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "90210",
            "telephone_number": "818-307-0074",
            "fax_number": "310-432-2889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N CRESCENT DR",
            "address_2": "STE 110",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "90210",
            "telephone_number": "310-432-2880",
            "fax_number": "310-432-2887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANARE SANCTUARY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-05",
        "last_updated": "2024-03-07",
        "status": "A",
        "authorized_official_last_name": "PECORARO",
        "authorized_official_first_name": "JOANN",
        "authorized_official_title_or_position": "BIZ MGR",
        "authorized_official_telephone_number": "818-307-0074"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; 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.