Beaver Medical Group P C
Organization Active NPI Internal Medicine Physician · Highland, CA
NPI 1598706293 · NPPES record last updated Aug 20, 2024
Key facts
- NPI
- 1598706293
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- BEAVER MEDICAL GROUP P C
- Practice address
- 7000 Boulder Ave
Highland, CA 92346-3348 - Phone
- (909) 862-1191
- Fax
- (909) 796-4158
- NPI assigned
- Jun 10, 2006
- Reactivated
- Nov 9, 2012
- Organization subpart
- No
Authorized official
- Name
- Emily Castillo
- Title
- Associate Director
- Phone
- (702) 480-2550
Other NPIs on the same Medicare enrollment 6
Other NPIs with the same Medicare PAC ID 7
Practitioners 251
-
Noura Aman, PA
-
Hanan Abu Alnaaj, MD
-
James E Agee, M.D.
-
Lindsay Anne Ahmed, M.D.
-
Nesib Ali, MD
-
Amanda Ardessi, FNP-C
-
William G Ayoub Jr., PA-C
-
Ghazal N Bahri, M.D.
-
Erik Bakken, M.D.
-
Augusto F Banayat, FNP
-
Steven Beck, M.D.
-
Brian Beitel, M.D.
-
Amandip Birdi, D.O.
-
Amy Blackmon, MD
-
Chad Brockardt, M.D.
-
Bobby J Bryant II, M.D.
-
Michelle Nicole Budd, PA-C
-
Carina D Buhay, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031124000449 | CA | Part B Supplier - Clinic/Group Practice | 0547164295 |
Receives reassigned benefits from 688 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Vista, CA; Yucaipa, CA; San Bernardino, CA; Redlands, CA; Banning, CA; Beaumont, CA; Carlsbad, CA; Colton, CA… |
| O20121129000152 | CA | DME Supplier - Multi-Specialty - Physician |
0547164295 | Practice locations: Highland, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician |
207N00000X | |||
| Emergency Medicine Physician |
207P00000X | |||
| Family Medicine Physician |
207Q00000X | |||
| Internal Medicine Physician |
207R00000X | Yes | ||
| Cardiovascular Disease Physician |
207RC0000X | |||
| Gastroenterology Physician |
207RG0100X | |||
| Hematology & Oncology Physician |
207RH0003X | |||
| Obstetrics & Gynecology Physician |
207V00000X | |||
| Orthopaedic Surgery Physician |
207X00000X | |||
| Otolaryngology Physician |
207Y00000X | |||
| Pediatrics Physician |
208000000X | |||
| Neurology Physician |
2084N0400X | |||
| Diagnostic Radiology Physician |
2085R0202X | |||
| Audiologist |
231H00000X |
Addresses
Primary practice location
7000 Boulder Ave
Highland, CA 92346-3348
Mailing address
PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 480-2550
Other providers in Highland, CA
- Gavrielle Concepcion Balibay
- Neida Barco
- Thomas Battaile Jr.
- Jenna Raelene Baumann
- Beaver Medical Group LP
- Beaver Medical Group, LP
- Claudia Virginia Becerra
- Brian Beitel
- John Beld
- Marian N.B. Beshara
All providers in Highland, CA · Internal Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.