Beverly Alliance Ipa

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

C3776980 Issued in CA

Legal business name

BEVERLY ALLIANCE IPA

Doing business as

Beverly Alianza Ipa

Practice address

17215 Studebaker Rd Ste 331
Cerritos, CA 90703-2557

Phone

(714) 495-4392

NPI assigned

Aug 14, 2015

Last updated

Aug 14, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Khalid Nur, M.D.

Title

Ceo

Phone

(714) 495-4392

Specialties & licenses 1

Addresses

Other names 1

• BEVERLY ALIANZA IPA Doing business as

Locations

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

{
    "created_epoch": "1439510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439510400000",
    "number": "1598131450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17215 STUDEBAKER RD STE 331",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032557",
            "telephone_number": "714-495-4392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17215 STUDEBAKER RD STE 331",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032557",
            "telephone_number": "714-495-4392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEVERLY ALLIANCE IPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-14",
        "last_updated": "2015-08-14",
        "status": "A",
        "authorized_official_last_name": "NUR",
        "authorized_official_first_name": "KHALID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-495-4392",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": "C3776980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BEVERLY ALIANZA IPA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Health Maintenance Organization in Cerritos, CA
• Providers in Cerritos, CA by specialty
• Health Maintenance Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.