BEAVER MEDICAL GROUP P C NPI 1649503319

NPI Information

  • NPI: 1649503319
  • Provider Name: BEAVER MEDICAL GROUP P C
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: OPTUM
  • Address: 2 WEST FERN AVENUE
    REDLANDS, CA
    ZIP 92373
  • Phone: (909) 793-3311

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NPI Details

BEAVER MEDICAL GROUP P C is a family medicine in Redlands, 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 P C NPI is 1649503319. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Optum.

The provider's business location address is:

2 WEST FERN AVENUE
REDLANDS, CA
ZIP 92373-916
Phone: (909) 793-3311
Fax: (909) 335-1936

The provider's authorized official is Emily Castillo .
The authorized official title is Associate Director and has the following contact phone number (702) 480-2550.

The enumeration date for this NPI number is 9/14/2009 and was last updated on 8/20/2024.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207L00000XAnesthesiologyNo
2207N00000XDermatologyNo
3207Q00000XFamily MedicineYes
4207R00000XInternal MedicineNo
5207RG0100XInternal MedicineGastroenterologyNo
6207RH0003XInternal MedicineHematology & OncologyNo
7207RR0500XInternal MedicineRheumatologyNo
8207V00000XObstetrics & GynecologyNo
9207W00000XOphthalmologyNo
10207X00000XOrthopaedic SurgeryNo
11208000000XPediatricsNo
122084N0400XPsychiatry & NeurologyNeurologyNo
132085R0202XRadiologyDiagnostic RadiologyNo
14208600000XSurgeryNo
15208800000XUrologyNo

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: 11/21/2025

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