BEAVER MEDICAL GROUP LP (NPI# 1629482641) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629482641 |
| Entity Type | Organization |
| Organization Name | BEAVER MEDICAL GROUP LP |
| Other Organization Name | BEAVER MEDICAL GROUP HIGHLAND SPRINGS |
| Practice Address |
81 Highland Springs Ave Suite 200 Beaumont CA 92223-3170 |
| Mailing Address |
9276 Scranton Rd Suite 100 San Diego CA 92121-7701 |
| Practice Telephone | 9518450313 |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2016-01-08 |
| 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 | A52212 | CA | Suppliers |
| Other Name | Type Code |
|---|---|
| Beaver Medical Group Highland Springs | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578991816 | Beaver Medical Group Lp | Non-Pharmacy Dispensing Site | 2 W Fern Ave, Suite 200, Redlands, CA 92373-5916 | 2013-10-24 |
| 1881857597 | Beaver Medical Group Lp | Non-Pharmacy Dispensing Site | 6109 W Ramsey St, Banning, CA 92220-3051 | 2008-07-03 |
| 1639344716 | Beaver Medical Group Lp | Non-Pharmacy Dispensing Site | 7000 Boulder Ave, Highland, CA 92346-3348 | 2008-04-29 |
| 1831377662 | Beaver Medical Group Lp | Non-Pharmacy Dispensing Site | 1300 E Cooley Dr, Colton, CA 92324-3905 | 2008-02-04 |
| 1205013323 | Beaver Medical Group Lp | Optometrist | 33758 Yucaipa Blvd, Yucaipa, CA 92399-2243 | 2008-01-31 |
| Street Address |
81 HIGHLAND SPRINGS AVE SUITE 200 |
| City | BEAUMONT |
| State | CA |
| Zip Code | 92223-3170 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053379768 | Lui Kong Yap | Physician Assistant | 81 Highland Springs Ave, Ste.200, Beaumont, CA 92223 | 2006-05-02 |
| 1174050611 | Saida Hardoon | Family Medicine | 81 Highland Springs Ave, Beaumont, CA 92223-3176 | 2017-05-15 |
| 1316381650 | Amar Dixit | Allergy & Immunology | 81 Highland Springs Ave, Beaumont, CA 92223-3176 | 2013-04-17 |
| 1124369087 | Douglas Stephan Anders | Family Medicine | 81 Highland Springs Ave, Suite 306, Beaumont, CA 92223-3170 | 2013-03-01 |
| 1790030773 | Seventh Day Adventists Loma Linda University Medical Center, Inc. | Pharmacy | 81 Highland Springs Ave, Suite 90, Beaumont, CA 92223-3170 | 2012-07-17 |
| 1093945578 | Loma Linda University Radiation Medicine | Radiology | 81 Highland Springs Ave, Beaumont, CA 92223-2511 | 2009-07-20 |
| 1871766121 | Faculty Physicians and Surgeons of Llusm | Pediatrics | 81 Highland Springs Ave, Beaumont, CA 92223-2511 | 2008-04-08 |
| 1982709432 | Mark Thomas Reis | Orthopaedic Surgery | 81 Highland Springs Ave, Suite 103, Beaumont, CA 92223-3170 | 2006-09-13 |
| 1407898646 | Sherif F. Khalil | Internal Medicine | 81 Highland Springs Ave, Ste 200, Beaumont, CA 92223 | 2006-06-12 |
| 1063452811 | Susannah Reay Elton | Physician Assistant | 81 Highland Springs Ave, Beaumont, CA 92223-3170 | 2006-06-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972115376 | National Vision Inc | Optometrist | 1561 East 2nd Street, Suite 300, Beaumont, CA 92223 | 2020-08-18 |
| 1417566985 | Krystle Santana | Marriage & Family Therapist | 14700 Manzanita Park Rd, Beaumont, Ca 9223, Beaumont, CA 92223 | 2020-07-30 |
| 1063045656 | Beaver Medical Group, L.p. | Durable Medical Equipment & Medical Supplies | 839 Highland Springs Parkway, Building C, Beaumont, CA 92223 | 2020-02-21 |
| 1730745969 | Paola Correa | Counselor | 24700 Manzanita Park Rd, Beaumont, CA 92223 | 2019-05-13 |
| 1639662802 | Jeremy Ball | Optometrist | 1659 E 6th St Ste A, Beaumont, CA 92223 | 2018-06-12 |
| 1659894368 | Jennifer Vargas | Counselor | 136 E. 6th St., Beaumont, CA 92223 | 2017-07-25 |
| 1770931487 | Amy Appleby | Student in an Organized Health Care Education/Training Program | 1360 Coriander Ct, Beaumont, CA 92223 | 2016-06-03 |
| 1427410364 | Jacob Garcia | Licensed Vocational Nurse | 38686 Florence Ave, Beaumont, CA 92223 | 2016-03-21 |
| 1396121588 | Anastasia B Flores | Counselor | 14700 Manzanita Park Rd., Beaumont, CA 92223 | 2015-08-11 |
| 1326424227 | Cindy Quyen Huynh | Dentist | 1620 E 2nd St Ste A, Beaumont, CA 92223 | 2015-08-03 |
| Find all providers in zip 92223 | ||||
| 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] |
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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 |
| Find all providers with the same taxonomy | ||||
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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.