NPI 1902390719 · live from the CMS NPI Registry
Beachside Clinic
Clinic/Center in Phoenix, AZ. National Provider Identifier 1902390719, active.
NPI record
| NPI | 1902390719 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Clinic/Center 261Q00000X |
| Practice location | 3213 E Libby St, Phoenix, AZ 85032 |
| Practice phone | 602-339-7392 |
| Enumerated | June 15, 2018 |
| Last updated | June 15, 2018 |
| Authorized official | Andrea Messeguer Najera, Coo |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Ambulance | 341600000X | — |
| Ambulance, Land Transport | 3416L0300X | — |
| Ambulance, Water Transport | 3416S0300X | — |
| Clinic/Center, Health Services | 261QH0100X | — |
| Clinic/Center, Radiology | 261QR0200X | — |
| Clinic/Center, Urgent Care | 261QU0200X | — |
| Pharmacy | 333600000X | — |
| Pharmacy, Clinic Pharmacy | 3336C0002X | — |
| Clinic/Center, Emergency Care | 261QE0002X | — |
| Clinic/Center primary | 261Q00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.