Organization · Type 2 NPI

Beaver Medical Group LP

Non-Pharmacy Dispensing Site · Highland, CA

NPI number 1639344716 Active

Practice location

7000 Boulder Ave
Highland, CA 92346-3348

Call (909) 862-1191 Map

Mailing address

9276 Scranton Rd, Suite 100
San Diego, CA 92121-7701

Specialties and licenses

Taxonomy	Code	License
Non-Pharmacy Dispensing Site Primary	332900000X	A69210 (CA)

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.)

77 other providers at this address

NPI record

NPI: 1639344716
Entity type: Organization (Type 2)
Issued: Apr 29, 2008
Last updated: Jun 9, 2016
Status: Active
Subpart: Yes of Medvantx, Inc.

Other names

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Beaver Medical Group - Highland Extended Care · doing business as

Authorized official

Kenny Heine
VP of Operations
(858) 625-2990

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1639344716

Beaver Medical Group LP's National Provider Identifier is 1639344716, issued on Apr 29, 2008. The primary taxonomy on file is Non-Pharmacy Dispensing Site (332900000X), and the practice location is in Highland, CA. The record was last updated on Jun 9, 2016.