Provider Demographics
NPI:1265782890
Name:BEVERLY ONCOLOGY MULTISPECIALTY GROUP MEDCIAL CORPORATION
Entity type:Organization
Organization Name:BEVERLY ONCOLOGY MULTISPECIALTY GROUP MEDCIAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:THROPAY
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:323-517-9800
Mailing Address - Street 1:200 E BEVERLY BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-7001
Mailing Address - Country:US
Mailing Address - Phone:323-517-9800
Mailing Address - Fax:323-727-7574
Practice Address - Street 1:18575 GALE AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:CITY OF INDUSTRY
Practice Address - State:CA
Practice Address - Zip Code:91748-1340
Practice Address - Country:US
Practice Address - Phone:626-810-6886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG32178174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1396932943OtherGROUP NPI
CA1720195977OtherINDIVIDUAL NPI
CA1184664377OtherINDIVIDUAL NPI
CA1396932943OtherGENERAL NPI
CA1679760227OtherNPI
CA1750302261OtherINDIVIDUAL NPI
CA1740350354OtherGROUP NPI
CA1427128073OtherINDIVIDUAL NPI
CA1033306683OtherNPI
CA1871663401OtherINDIVIDUAL NPI
CAW5769Medicare PIN
CA1184664377OtherINDIVIDUAL NPI
CAW5769CMedicare PIN
CA1750302261OtherINDIVIDUAL NPI
CA1427128073OtherINDIVIDUAL NPI