R Ray Nettles MD Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

R RAY NETTLES MD INC

Practice address

9454 Wilshire Blvd
#300
Beverly Hills, CA 90212

Phone

(310) 601-4778

Fax

(800) 877-3725

NPI assigned

Jun 8, 2017

Organization subpart

No

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

Authorized official

Name

Lorena B Mandi

Title

Secretary

Phone

(310) 601-4778

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1699204032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9454 WILSHIRE BLVD STE 300",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902122904",
            "telephone_number": "310-601-4778",
            "fax_number": "800-877-3725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9454 WILSHIRE BLVD",
            "address_2": "#300",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "90212",
            "telephone_number": "310-601-4778",
            "fax_number": "800-877-3725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R RAY NETTLES MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-08",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MANDI",
        "authorized_official_first_name": "LORENA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "310-601-4778"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.