Beaver Medical Group LP
NPI #1831377662 in Colton, California
Provider Information
- NPI Number
- 1831377662
- Entity Type
- Organization
- Organization Name
- Beaver Medical Group LP
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- MEDVANTX, INC.
- Primary Specialty
- Non-Pharmacy Dispensing Site
- Enumeration Date
- Feb 4, 2008
- Last Updated
- Apr 25, 2013
Practice Location
- Address
- 1300 E COOLEY DR
- City
- Colton
- State
- California
- ZIP Code
- 92324-3905
- Phone
- (909) 270-4179
Authorized Official
- Name
- KENNY HEINE
- Title
- VP OF OPERATIONS
- Phone
- (858) 625-2990
Specialties & Taxonomy Codes
| Specialty |
|---|
| Non-Pharmacy Dispensing Site |
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