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BEAVER MEDICAL GROUP LP NPI 1205013323


NPI Information

NPI: 1205013323
Provider Name: BEAVER MEDICAL GROUP LP
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 05D0929913

Address:
33758 YUCAIPA BLVD
YUCAIPA, CA
ZIP 92399
Phone: (909) 795-9747
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BEAVER MEDICAL GROUP LP is a family medicine in Yucaipa, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. BEAVER MEDICAL GROUP LP NPI is 1205013323. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

33758 YUCAIPA BLVD
YUCAIPA, CA
ZIP 92399-243
Phone: (909) 795-9747
Fax: (909) 795-4663

The provider's authorized official is Dennis Patrick Flynn .
The authorized official title is Vice President Of Medical Affairs and has the following contact phone number (909) 799-1818.

The CLIA number assigned to this NPI record is 05D0929913 - community clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 1/31/2008 and was last updated on 11/9/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1152W00000XOptometristNo
2207N00000XDermatologyNo
3207R00000XInternal MedicineNo
4207W00000XOphthalmologyNo
5207X00000XOrthopaedic SurgeryNo
6208000000XPediatricsNo
7207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.