Jorge Beanato

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · San Pedro, CA

NPI 1669928701 · NPPES record last updated Aug 29, 2016

Key facts

NPI
1669928701
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
1891 N Gaffey St
Suite 228
San Pedro, CA 90731-1267
Phone
(310) 514-5500
NPI assigned
Aug 29, 2016
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

1891 N Gaffey St
Suite 228
San Pedro, CA 90731-1267

Mailing address

456 Elm Ave
Long Beach, CA 90802-2426
Phone (562) 437-6717

Other providers in San Pedro, CA

All providers in San Pedro, CA · Student in an Organized Health Care Education/Training Program in California

Sources for this page

Verify at the official NPI Registry.