Provider Demographics
NPI:1366759771
Name:BPP MEDICAL SERVICES INC
Entity type:Organization
Organization Name:BPP MEDICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:J
Authorized Official - Last Name:BERON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-385-1721
Mailing Address - Street 1:311 N ROBERTSON BLVD
Mailing Address - Street 2:612
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-1705
Mailing Address - Country:US
Mailing Address - Phone:714-385-1721
Mailing Address - Fax:714-385-1723
Practice Address - Street 1:3400 W BALL RD
Practice Address - Street 2:101
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-3738
Practice Address - Country:US
Practice Address - Phone:714-385-1721
Practice Address - Fax:714-385-1723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-07
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG810892085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty