Pismo Wellness Inc., a Professional Medical Corporation

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

PISMO WELLNESS INC., A PROFESSIONAL MEDICAL CORPORATION

Practice address

8500 Wilshire Blvd
Suite 103
Beverly Hills, CA 90211

Phone

(424) 307-9504

NPI assigned

Oct 8, 2018

Last updated

Feb 14, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Jessie Martori

Title

Manager

Phone

(602) 920-4290

Specialties & licenses 3

Addresses

Electronic endpoints 1

Practitioners 1

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.

• Alexander G Stein, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Fargo, ND
  • NPI 1861440430
  NPD

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

{
    "created_epoch": "1538956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644796800000",
    "number": "1841765674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8500 WILSHIRE BLVD",
            "address_2": "SUITE 103",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "90211",
            "telephone_number": "424-307-9504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8500 WILSHIRE BLVD",
            "address_2": "SUITE 103",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "90211",
            "telephone_number": "424-307-9504"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "391 Front St Ste F",
            "address_purpose": "LOCATION",
            "city": "Grover Beach",
            "state": "CA",
            "postal_code": "934331553",
            "country_code": "US",
            "telephone_number": "805-219-6634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PISMO WELLNESS INC., A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-08",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A",
        "authorized_official_last_name": "MARTORI",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "602-920-4290",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "mindmdwellness.com",
            "affiliation": "N",
            "endpointDescription": "practice URL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "General Practice Information",
            "address_1": "8500 Wilshire Blvd Ste 103",
            "city": "Beverly Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902113110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinic/Center in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.