Gary S Bellack MD Inc

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

C42325 Issued in CA

Legal business name

GARY S BELLACK MD INC

Practice address

8631 W Third St
Suite 225
Los Angeles, CA 90048-5901

Phone

(310) 659-3938

NPI assigned

May 30, 2008

Organization subpart

No

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

Authorized official

Name

Gary Bellack, MDNPI 1750442448

Title

Owner

Phone

(310) 659-3938

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Gary S Bellack, MD

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Los Angeles, CA
  • NPI 1750442448
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425945600000",
    "number": "1588822100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8631 W THIRD ST",
            "address_2": "SUITE 225",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485901",
            "telephone_number": "310-659-3938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8631 W THIRD ST",
            "address_2": "SUITE 225",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485901",
            "telephone_number": "310-659-3938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY S BELLACK MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-30",
        "last_updated": "2015-03-10",
        "status": "A",
        "authorized_official_last_name": "BELLACK",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-659-3938",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "C42325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C423250",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gary M Tearston MD a Medical Corp
• Gary Manukyan DDS,Inc.
• Gary Motykie, M.D. a Medical Corporation
• Gary R. Massa DDS, MSD, Inc.
• Gary Reznik M. D. Inc
• Gary Tchobanian Chiropractic Corporation
• Cyril Sergei Gary, MD
• Joshua Layne Gary, MD
• Norianna Ariel Gary
• Hernan Garza Villarreal

• Otolaryngology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2015; 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.