NPIMap

Organization Active NPI

Beverly Hills Medical Corporation

  • General Practice Physician
  • Culver City, CA
National Provider Identifier
1740213222
Registry record updated Sep 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
BEVERLY HILLS MEDICAL CORPORATION
Practice address
9808 Venice Blvd
Suite 503
Culver City, CA 90232-6804
Phone
(310) 204-5510
Fax
(310) 204-5518
NPI assigned
Jul 8, 2006
Last updated
Sep 19, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2014

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

Authorized official

Name
Dr. Ali Hadadz, MDNPI 1316970866
Title
President
Phone
(310) 274-5510

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

9808 Venice Blvd
Suite 503
Culver City, CA 90232-6804

Mailing address

9808 Venice Blvd
Suite 503
Culver City, CA 90232-6804
Phone (310) 204-5510

Other identifiers 3

IdentifierTypeStateIssuer
010066259OtherCAMEDICARE RAILROAD
00A698160MedicaidCA
ZZZ05665ZOtherCABLUE SHIELD CA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090820000247 CA Part B Supplier - Clinic/Group Practice 5294889515 Receives reassigned benefits from 7 practitioners
Practice locations: Marina del Rey, CA

National Provider Directory

National Provider Directory

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411084800000",
    "number": "1740213222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9808 VENICE BLVD",
            "address_2": "SUITE 503",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902326804",
            "telephone_number": "310-204-5510",
            "fax_number": "310-204-5518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9808 VENICE BLVD",
            "address_2": "SUITE 503",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902326804",
            "telephone_number": "310-204-5510",
            "fax_number": "310-204-5518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEVERLY HILLS MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2014-09-19",
        "status": "A",
        "authorized_official_last_name": "HADADZ",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-274-5510",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "010066259",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A698160",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD CA",
            "identifier": "ZZZ05665Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.