Jose Beltran
Individual provider Active NPI Driver · Marina, CA
NPI 1114665155 · NPPES record last updated May 20, 2022
Key facts
- NPI
- 1114665155
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 474 Logan Way
Marina, CA 93933-5204 - Phone
- (831) 512-6291
- NPI assigned
- May 20, 2022
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F7877188 | CA | MD | Driver |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peninsula Non Emergency Medical Transportation LLC | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | F7877188 | CA | |
| Driver | 172A00000X | Yes |
Addresses
Primary practice location
474 Logan Way
Marina, CA 93933-5204
Mailing address
474 Logan Way
Marina, CA 93933-5204
Phone (831) 512-6291
Other providers in Marina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.