1760282990 NPI number — BEHUMAN MEDICAL GROUP CALIFORNIA, P.C.

Table of content: (NPI 1760282990)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760282990 NPI number — BEHUMAN MEDICAL GROUP CALIFORNIA, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BEHUMAN MEDICAL GROUP CALIFORNIA, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1760282990
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/21/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16442 NE 31ST AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH MIAMI BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33160-4135
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-523-9787
Provider Business Mailing Address Fax Number:
754-310-1422

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2512 SAMARITAN CT STE G
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN JOSE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95124-4002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-523-9787
Provider Business Practice Location Address Fax Number:
754-310-1422
Provider Enumeration Date:
03/17/2025

Additional Information

Authorized Official

Authorized Official Last Name:
YASKIN
Authorized Official First Name:
INNA
Authorized Official Middle Name:
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
305-523-9787

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com