BEAVER MEDICAL GROUP LP NPI 1881857597

NPI Information

BEAVER MEDICAL GROUP LP is a non pharmacy dispensing site in Banning, CA. The provider is a site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) BEAVER MEDICAL GROUP LP NPI is 1881857597. The provider is registered as an organization entity type.
The provider Is Doing Business As Beaver Medical Group - Banning Extended Care.

The provider's business location address is:

6109 W RAMSEY ST
BANNING, CA
ZIP 92220-051
Phone: (951) 845-0313

The provider's authorized official is Kenny Heine .
The authorized official title is Vp Of Operations and has the following contact phone number (858) 625-2990.

The CLIA number assigned to this NPI record is 05D1019975 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 7/3/2008 and was last updated on 4/25/2013.

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:

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