NPIMap

Organization Active NPI

Elite Integrative Medical

  • General Practice Physician
  • Beverly Hills, CA
National Provider Identifier
1760006712
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
ELITE INTEGRATIVE MEDICAL
Practice address
153 S Doheny Dr
Beverly Hills, CA 90211-2509
Phone
(310) 888-8896
NPI assigned
Jun 5, 2020
Last updated
Sep 29, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
BERK CHIROPRACTIC, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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

Authorized official

Name
Dr. Evan Bruce Berk, DCNPI 1609980200
Title
President
Phone
(310) 888-8896

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X NU
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

153 S Doheny Dr
Beverly Hills, CA 90211-2509

Mailing address

153 S Doheny Dr
Beverly Hills, CA 90211-2509
Phone (310) 888-8896

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL info.berkchiro@gmail.com

National Provider Directory

National Provider Directory
Part of
Berk Chiropractic Inc

Locations

153 S Doheny Dr
Beverly Hills, CA 90211
Phone (310) 888-8896

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 5

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": "1591315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632873600000",
    "number": "1760006712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 S DOHENY DR",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112509",
            "telephone_number": "310-888-8896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 S DOHENY DR",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112509",
            "telephone_number": "310-888-8896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE INTEGRATIVE MEDICAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BERK CHIROPRACTIC, INC.",
        "enumeration_date": "2020-06-05",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A",
        "authorized_official_last_name": "BERK",
        "authorized_official_first_name": "EVAN",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-888-8896",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "info.berkchiro@gmail.com",
            "affiliation": "N",
            "address_1": "153 S Doheny Dr",
            "city": "Beverly Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902112509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; 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.