Chung Medical Corporation, Inc

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

RHM53835G Issued in CA

Legal business name

CHUNG MEDICAL CORPORATION, INC

Doing business as

BEVERLY MEDICAL CENTER, INC

Practice address

8401 California City Blvd
Suite 7
California City, CA 93505-5277

Phone

(760) 373-1150

Fax

(760) 373-7841

NPI assigned

Jun 1, 2006

Organization subpart

No

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

Authorized official

Name

Beverly Elaine Thorbus, R.N.

Title

Owner / Administrator

Phone

(760) 382-3505

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• BEVERLY MEDICAL CENTER, INC Doing business as

Locations

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226361600000",
    "number": "1649217431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8401 CALIFORNIA CITY BLVD",
            "address_2": "SUITE 7",
            "city": "CALIFORNIA CITY",
            "state": "CA",
            "postal_code": "935055277",
            "telephone_number": "760-373-1150",
            "fax_number": "760-373-7841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 CALIFORNIA CITY BLVD",
            "address_2": "SUITE 7",
            "city": "CALIFORNIA CITY",
            "state": "CA",
            "postal_code": "935055277",
            "telephone_number": "760-373-1150",
            "fax_number": "760-373-7841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHUNG MEDICAL CORPORATION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2008-11-11",
        "status": "A",
        "authorized_official_last_name": "THORBUS",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "OWNER / ADMINISTRATOR",
        "authorized_official_telephone_number": "760-382-3505",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "CA",
            "license": "RHM53835G",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM53835G",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HAP53835G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BEVERLY MEDICAL CENTER, INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2008; 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.