Beacon Medical Management LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

BEACON MEDICAL MANAGEMENT LLC

Practice address

13372 Newport Ave Ste I
Tustin, CA 92780-3426

Phone

(714) 731-9355

Fax

(714) 731-9350

NPI assigned

May 22, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Jennifer Jeanne Milam

Title

Owner

Phone

(714) 731-9355

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1337644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337644800000",
    "number": "1902166085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13372 NEWPORT AVE STE I",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803426",
            "telephone_number": "714-731-9355",
            "fax_number": "714-731-9350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13372 NEWPORT AVE STE I",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803426",
            "telephone_number": "714-731-9355",
            "fax_number": "714-731-9350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON MEDICAL MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-22",
        "last_updated": "2012-05-22",
        "status": "A",
        "authorized_official_last_name": "MILAM",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "JEANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-731-9355",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Huda Makram Bayaa, LMFT, LPCC
• Stephanie Bayly, LPCC
• Justin Philip Baytosh
• Tabatha Nicole Bazzell, B.S
• Beachside Recovery Center LLC
• Jinice Ann Beacon, MFT
• Alixandra Beaty, DC
• Brittany Beauchamp
• Mackenzie Beckely, LEP, PPSP
• Eun Neyer Beenen, ACSW

• General Practice Physician in Tustin, CA
• Providers in Tustin, 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 May 22, 2012; 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.