Provider Demographics
NPI:1861598757
Name:BEVERLY HILLS GROUP OF WOMEN PHYSICIANS
Entity type:Organization
Organization Name:BEVERLY HILLS GROUP OF WOMEN PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANETH
Authorized Official - Middle Name:
Authorized Official - Last Name:CORONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-659-4052
Mailing Address - Street 1:8641 WILSHIRE BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2919
Mailing Address - Country:US
Mailing Address - Phone:310-659-6210
Mailing Address - Fax:310-659-5185
Practice Address - Street 1:8641 WILSHIRE BLVD STE 102
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2919
Practice Address - Country:US
Practice Address - Phone:310-659-6210
Practice Address - Fax:310-659-5185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG65679174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA77836OtherDR. LILY P. LEE CA LICENS
CAH46141Medicare UPIN
CAG07966Medicare UPIN
CAG56996Medicare UPIN
CAF36631Medicare UPIN