BEAVER MEDICAL GROUP RAMSEY PRIMARY (NPI# 1437564143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437564143 |
| Entity Type | Organization |
| Organization Name | BEAVER MEDICAL GROUP RAMSEY PRIMARY |
| Other Organization Name | BEAVER MEDICAL GROUP LP |
| Practice Address |
5957 W Ramsey St Second Floor Pod D Banning CA 92220-3058 |
| Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
| Practice Telephone | 9518450313 |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2014-06-23 |
| Authorized Official Name | KENNY HEINE (VP OF OPERATIONS) |
| Authorized Official Telephone | 8589641506 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDVANTX, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | 107871 | CA | Suppliers |
| Other Name | Type Code |
|---|---|
| Beaver Medical Group LP | Doing Business As Name - Organization |
| Street Address |
5957 W RAMSEY ST SECOND FLOOR POD D |
| City | BANNING |
| State | CA |
| Zip Code | 92220-3058 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699715714 | Glenda M. Yetter | Nurse Practitioner | 5957 W Ramsey St, Banning, CA 92220-3058 | 2006-06-07 |
| 1679944565 | Cindy Lerch | Physician Assistant | 5957 W Ramsey St, Banning, CA 92220-3058 | 2015-10-17 |
| 1487085403 | Janet Cooper | Nurse Practitioner | 5957 W Ramsey St, Banning, CA 92220-3058 | 2013-12-01 |
| 1316240971 | Susan Jane Sheedy | Nurse Practitioner | 5957 W Ramsey St, Banning, CA 92220-3058 | 2010-12-20 |
| 1447564513 | Hong Vo | Internal Medicine | 5957 W Ramsey St, Banning, CA 92220-3058 | 2010-08-01 |
| 1861705030 | Todd Nguyen | Family Medicine | 5957 W Ramsey St, Banning, CA 92220-3058 | 2010-07-16 |
| 1558525220 | Robert Reagan Suong | Obstetrics & Gynecology | 5957 W Ramsey St, Banning, CA 92220-3058 | 2008-07-11 |
| 1598922882 | Susanna Nicholass | Family Medicine | 5957 W Ramsey St, Banning, CA 92220-3058 | 2008-05-22 |
| 1508052010 | Mark Anthony Mayrina Santos | Family Medicine | 5957 W Ramsey St, Banning, CA 92220-3058 | 2007-09-18 |
| 1457372179 | Beaver Medical Group, Lp | Family Medicine | 5957 W Ramsey St, Banning, CA 92220-3058 | 2006-07-21 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962056523 | Golden View Guest Home, Inc. | Assisted Living Facility | 5466 West Wilson, Banning, CA 92220 | 2019-07-31 |
| 1780246157 | Fjs Hearing Professionals | Hearing Instrument Specialist | 3559 W Ramsey Ave Suit C-2, Banning, CA 92220 | 2019-07-05 |
| 1790237832 | Jennifer De Geus | Counselor | 1627 Hargrave St., Banning, CA 92220 | 2016-10-25 |
| 1427447507 | Dalonna Blackwell | Counselor | 2781 W. Ramsey St., Banning, CA 92220 | 2015-01-13 |
| 1639575962 | Eunjung J. Jung Choi | Dentist | 300 S Highland Springs Ave Ste 2l, Banning, CA 92220 | 2014-11-13 |
| 1861810244 | Genevra Diana Glenn | Counselor | 2781 W Ramsey, Suite 1, Banning, CA 92220 | 2014-04-02 |
| 1841617420 | Kristen Lew | Internal Medicine | 6109 W.ramsey Street, Banning, CA 92220 | 2014-03-21 |
| 1588917884 | Jamison William Murphy | Military Health Care Provider | Uss Howard Ddg 83, Fpo, AP 92220 | 2012-10-24 |
| 1972871390 | John Hong | Pharmacist | 60 N Highlandsprings, Beaumont, CA 92220 | 2011-12-13 |
| 1679855936 | Lydia Session | Marriage & Family Therapist | 1627 S. Hargrave, Banning, CA 92220 | 2011-09-13 |
| Find all providers in zip 92220 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881857597 | Beaver Medical Group Lp | Non-Pharmacy Dispensing Site | 6109 W Ramsey St, Banning, CA 92220-3051 | 2008-07-03 |
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| 1790327732 | Triumph Specialties LLC | Non-Pharmacy Dispensing Site | 11100 Sepulveda Blvd # 8-519, Mission Hills, CA 91345-1131 | 2019-10-10 |
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| 1376030080 | Jane F Kardashian Md Inc | Non-Pharmacy Dispensing Site | 6769 N Fresno, Fresno, CA 93710 | 2018-04-18 |
| 1023511045 | Performance Health Medical Group | Non-Pharmacy Dispensing Site | 25431 Cabot Road Suite 118, Laguna Hills, CA 92653 | 2018-03-15 |
| 1043719206 | Southern California Orthopedic Institute L.p | Non-Pharmacy Dispensing Site | 4100 Empire Dr Ste 120, Bakersfield, CA 93309-0408 | 2018-02-02 |
| 1174032353 | Golden Gate Urology, Inc. | Non-Pharmacy Dispensing Site | 139 Townsend St Ste 100, San Francisco, CA 94107-1946 | 2017-09-20 |
| 1215462080 | Mas Management Group, Inc. | Non-Pharmacy Dispensing Site | 28446 Constellation Rd, Valencia, CA 91355-5081 | 2017-04-28 |
| 1730624719 | St. John's Well Child and Family Center Inc | Non-Pharmacy Dispensing Site | 326 W 23rd St, Los Angeles, CA 90007-2612 | 2016-12-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.