| Beaver Medical Group, Lp | |
|
5957 W Ramsey St Banning CA 92220-3058 | |
| (951) 845-0313 | |
| (909) 796-4158 |
| Full Name | Beaver Medical Group, Lp |
|---|---|
| Speciality | Pediatrics |
| Location | 5957 W Ramsey St, Banning, California |
| Authorized Official Name and Position | Dennis P Flynn (VICE PRESIDENT OF MEDICAL AFFAIRS) |
| Authorized Official Contact | 9518450313 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beaver Medical Group, Lp Po Box 2200 Redlands CA 92373-0722 Ph: (909) 793-3311 | Beaver Medical Group, Lp 5957 W Ramsey St Banning CA 92220-3058 Ph: (951) 845-0313 |
| NPI Number | 1457372179 |
|---|---|
| Provider Enumeration Date | 07/21/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0547164295 |
|---|---|
| Medicare Enrollment ID | O20131030001327 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457372179 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208000000X | Pediatrics | (* (Not Available)) | Primary |
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