Owen R Mcivor, MD | |
7000 Boulder Ave, Highland, CA 92346-3348 | |
(909) 862-1191 | |
(909) 796-4158 |
Full Name | Owen R Mcivor |
---|---|
Gender | Male |
Speciality | Orthopaedic Surgery |
Location | 7000 Boulder Ave, Highland, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1538108337 | NPI | - | NPPES |
00G678420 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207X00000X | Orthopaedic Surgery | G67842 (California) | Primary |
Entity Name | Beaver Medical Group Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1649503319 PECOS PAC ID: 0547164295 Enrollment ID: O20031124000449 |
Mailing Address | Practice Location Address |
---|---|
Owen R Mcivor, MD Po Box 10069, San Bernardino, CA 92423-0069 Ph: (909) 335-4188 | Owen R Mcivor, MD 7000 Boulder Ave, Highland, CA 92346-3348 Ph: (909) 862-1191 |
Andrew Tyler, PA Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 7000 Boulder Ave, Highland, CA 92346 Phone: 909-862-1191 | |
Michael J Coen, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 7000 Boulder Ave, Highland, CA 92346 Phone: 909-862-1191 | |
Dr. Chad Brockardt, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 7000 Boulder Ave, Highland, CA 92346 Phone: 909-862-1191 | |
Dr. Rebecca Griffith, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 7000 Boulder Ave, Highland, CA 92346 Phone: 909-862-1191 |