Forrest C Jellison (NPI# 1508073511, PAC ID# 8022295799) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is UROLOGY.
| Nation Provider ID (NPI) | 1508073511 |
| PAC ID by PECOS | 8022295799 |
| Professional Enrollment ID | I20110606000533 |
| Full Name | Forrest C Jellison |
| Organization Legal Name | BEAVER MEDICAL GROUP, L.P. |
| Address |
6109 W Ramsey St Banning CA 92220-3051 |
| Phone Number | 9098450313 |
| Gender | M |
| Medical School | LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2005 |
| Primary Specialty | UROLOGY |
| Group Practice PAC ID | 0547164295 |
| Number of Group Practice Members | 281 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050292 | RIVERSIDE UNIVERSITY HEALTH SYSTEM-MEDICAL CENTER |
| 050327 | LOMA LINDA UNIVERSITY MEDICAL CENTER |
| 050245 | ARROWHEAD REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 6109 W Ramsey St, Banning, CA 92220-3051 | 9098450313 | BEAVER MEDICAL GROUP, L.P. |
| 11234 Anderson St, Loma Linda, CA 92354-2804 | FACULTY PHYSICIANS AND SURGEONS OF LLUSM | |
| 11370 Anderson St, Loma Linda, CA 92354-3450 | FACULTY PHYSICIANS AND SURGEONS OF LLUSM | |
| 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | FACULTY PHYSICIANS AND SURGEONS OF LLUSM | |
| 26520 Cactus Ave, Suite 2021, Moreno Valley, CA 92555-3927 | 9514865700 | FACULTY PHYSICIANS AND SURGEONS OF LLUSM |
| 26780 Barton Rd, Redlands, CA 92373-4308 | 9095585174 | FACULTY PHYSICIANS AND SURGEONS OF LLUSM |
| Organization Legal Name | BEAVER MEDICAL GROUP, L.P. |
| Physicians | 323 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Andrew Tyler | Physician Assistant | Beaver Medical Group, L.p. | 81 Highland Springs Ave, Suite 200, Beaumont, CA 92223-3170 |
| Prince C Esiobu | Vascular Surgery | Beaver Medical Group, L.p. | 245 Terracina Blvd, Suite 202, Redlands, CA 92373-4867 |
| Madeline R Deutsch | Hospitalist | Beaver Medical Group, L.p. | 2 W Fern Ave, Redlands, CA 92373-5916 |
| Mi La Kim | Nurse Practitioner | Beaver Medical Group, L.p. | 33758 Yucaipa Blvd, Yucaipa, CA 92399-2243 |
| Katrina Carter | Family Medicine | Beaver Medical Group, L.p. | 1600 E Citrus Ave, Suite A, Redlands, CA 92374-4802 |
| Chad J Brockardt | Orthopedic Surgery | Beaver Medical Group, L.p. | 7000 Boulder Ave, Highland, CA 92346-3348 |
| Tonya Ann Yoney | Family Medicine | Beaver Medical Group, L.p. | 5957 W Ramsey St, Banning, CA 92220-3058 |
| Edmund Ko | Urology | Beaver Medical Group, L.p. | 6109 W Ramsey St, Banning, CA 92220-3051 |
| Glen R Gaerte | Optometry | Beaver Medical Group, L.p. | 1300 E Cooley Dr, Colton, CA 92324-3905 |
| Michael G Leong | Family Medicine | Beaver Medical Group, L.p. | 7223 Church St C, Highland, CA 92346-5816 |
| Street Address |
6109 W RAMSEY ST |
| City | BANNING |
| State | CA |
| Zip | 92220-3051 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Edmund Ko | Urology | Beaver Medical Group, L.p. | 6109 W Ramsey St, Banning, CA 92220-3051 |
| Lui Kong Yap | Physician Assistant | Beaver Medical Group, L.p. | 6109 W Ramsey St, Banning, CA 92220-3051 |
| Charles Chen | Internal Medicine | Beaver Medical Group, L.p. | 6109 W Ramsey St, Banning, CA 92220-3051 |
| Michael K Yoon | Ophthalmology | Beaver Medical Group, L.p. | 6109 W Ramsey St, Banning, CA 92220-3051 |
| Roger D Seheult | Pulmonary Disease | Beaver Medical Group, L.p. | 6109 W Ramsey St, Banning, CA 92220-3051 |
| Carri Ranie Lakes | Nurse Practitioner | Beaver Medical Group, L.p. | 6109 W Ramsey St, Banning, CA 92220-3051 |
| Zakia Raana | Family Medicine | Beaver Medical Group, L.p. | 6109 W Ramsey St, Banning, CA 92220-3051 |
| Mohammad Hajiha | Urology | Beaver Medical Group, L.p. | 6109 W Ramsey St, Banning, CA 92220-3051 |
| Mark T Dickinson | Urology | Beaver Medical Group, L.p. | 6109 W Ramsey St, Banning, CA 92220-3051 |
| Junku J Kang | Internal Medicine | Beaver Medical Group, L.p. | 6109 W Ramsey St, Banning, CA 92220-3051 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Waheed A Saeed | Psychiatry | County of Riverside | 1330 W Ramsey, Suite 100, Banning, CA 92220 |
| Nellie T Anosa | Psychiatry | County of Riverside | 1330 W Ramsey, Suite 100, Banning, CA 92220 |
| Susan L Jacobs | Clinical Social Worker | County of Riverside | 1330 W Ramsey, Suite 100, Banning, CA 92220 |
| Kenneth Levin | Psychiatry | County of Riverside | 1330 W Ramsey, Suite 100, Banning, CA 92220 |
| Cornelius John Driscoll | Clinical Social Worker | County of Riverside | 1330 W Ramsey, Suite 100, Banning, CA 92220 |
| Lydia A Roybal-aragon | Psychiatry | County of Riverside | 1330 W Ramsey, Banning, CA 92220 |
| Jonson J Lin | Psychiatry | County of Riverside | 1330 W Ramsey, Suite 100, Banning, CA 92220 |
| Farshid Yadegar | Psychologist, Clinical | Concept Healthcare Psychology Group,inc. | 5800 W Wilson St, Cherry Valley Healthcare, Banning, CA 92220-3042 |
| Michael P Sloan | Psychologist, Clinical | 264 N Highland Springs Ave, Suite 1c, Banning, CA 92220-3045 | |
| Michelle M Brilee | Nurse Practitioner | California Em-i Medical Services A Medical Corporation | 600 N Highland Springs Ave, Banning, CA 92220-3046 |
| Find all physicians in zip 92220 | |||
| City | BANNING |
| Zip Code | 92220 |
| Specialty | UROLOGY |
| City + Specialty | BANNING + UROLOGY |
Please comment or provide details below to improve the information on Forrest C Jellison.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.