Beaver Medical Group P C

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

BEAVER MEDICAL GROUP P C

Practice address

81 South Highland Springs Avenue
Suite 101 & 200
Beaumont, CA 92223-3170

Phone

(951) 845-0313

Fax

(951) 849-3225

NPI assigned

Nov 15, 2012

Last updated

Jul 24, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

BEAVER MEDICAL GROUP P CAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Emily Castillo

Title

Associate Director

Phone

(702) 480-2550

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Beaver Medical Group P C

  • Internal Medicine Physician
  • Colton, CA
  • NPI 1144265919

  0547164295

  Same PAC ID
• Beaver Medical Group P C

  dba Beaver Advantage Health Center

  • Family Medicine Physician
  • Redlands, CA
  • NPI 1275570830

  0547164295

  Same PAC ID
• Beaver Medical Group P C

  • Physical Therapist
  • Redlands, CA
  • NPI 1427090281

  0547164295

  Same PAC ID
• Beaver Medical Group P C

  • Internal Medicine Physician
  • Highland, CA
  • NPI 1598706293

  0547164295

  Same PAC ID
• Beaver Medical Group P C

  dba Optum Banner Specialty Care

  • Internal Medicine Physician
  • Banning, CA
  • NPI 1619914959

  0547164295

  Same PAC ID
• Beaver Medical Group P C

  dba Optum

  • Family Medicine Physician
  • Redlands, CA
  • NPI 1649503319

  0547164295

  Same PAC ID
• Beaver Medical Group P C

  • Durable Medical Equipment & Medical Supplies
  • Redlands, CA
  • NPI 1790029759

  0547164295

  Same PAC ID

Part of

Beaver Medical Group P C

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1609110667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-480-2550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 SOUTH HIGHLAND SPRINGS AVENUE",
            "address_2": "SUITE 101 & 200",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922233170",
            "telephone_number": "951-845-0313",
            "fax_number": "951-849-3225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAVER MEDICAL GROUP P C",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BEAVER MEDICAL GROUP P C",
        "enumeration_date": "2012-11-15",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "CASTILLO",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "ASSOCIATE DIRECTOR",
        "authorized_official_telephone_number": "702-480-2550"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beaumont SNF Healthcare, LLC (Vista Real Post Acute)
• Beaumont Unified School District (Beaumont USD)
• Beaver Medical Group LP (Beaver Medical Group Highland Springs)
• Beaver Medical Group P C
• Beaver Medical Group P C
• Amanda Louise Bell
• Millard Bell
• Beltone Hearing Aid Center
• Taiye Beoghene
• Jessica Betts

• Durable Medical Equipment & Medical Supplies in Beaumont, CA
• Providers in Beaumont, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.