Bea Medical Group, Inc.
Organization Active NPI Adult Medicine Physician · Cupertino, CA
NPI 1679533780 · NPPES record last updated Apr 26, 2022
Key facts
- NPI
- 1679533780
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Adult Medicine Physician 207QA0505X
- License
- FNP 34120 (CA)
- Legal business name
- BEA MEDICAL GROUP, INC.
- Practice address
- 10070 Pasadena Ave
Ste 2
Cupertino, CA 95014-5942 - Phone
- (408) 746-0300
- NPI assigned
- Mar 23, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Laura Stevens, M.D.
- Title
- Ceo, Cfo, President, & Founder
- Phone
- (408) 746-0300
Practitioners 1
-
Laura Stevens, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D0720545 | Bea Medical Group, Inc | Certificate of waiver | Oct 5, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070117000364 | CA | Part B Supplier - Clinic/Group Practice | 9537160528 |
Receives reassigned benefits from 1 practitioner Practice locations: Cupertino, CA; Sunnyvale, CA |
National Provider Directory
Locations
10070 Pasadena Ave
Ste 2
Cupertino, CA 95014
Phone (408) 746-0300
877 W Fremont Ave
Ste B1
Sunnyvale, CA 94087
Phone (408) 746-0300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician |
207QA0505X | FNP 34120 | CA | Yes |
| Primary Care Clinic/Center | 261QP2300X | CLM 311477 | CA |
Addresses
Primary practice location
10070 Pasadena Ave
Ste 2
Cupertino, CA 95014-5942
Mailing address
10070 Pasadena Ave
Ste 2
Cupertino, CA 95014-5942
Phone (408) 746-0300
Other providers in Cupertino, CA
- Bay Area Foot Care, Inc.
- Bay Area Maternity Midwifery, Registered Nursing and Women'S Health
- Bay Area Midwifery,Registered Nursing and Women'S Health,PC
- Kimberly Lynn Bayerbach
- Be Well Health LLC
- Marie-Nathalie Beaudoin
- Sara Jessica Beitler
- Diana Marie Belli
- Carla Zuleidi Beltran Solano
- Brenna Grace Bentley
All providers in Cupertino, CA · Adult Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 26, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.