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Organization
BEAVER MEDICAL GROUP PC
Active
Organization
BEAVER MEDICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES CHEN M.D. (CHIEF MEDICAL OFFICER)
(909) 793-3311
Entity
Organization
Contact information
Practice address
33758 YUCAIPA BLVD, YUCAIPA, CA 92399-2243
(909) 795-9747
(909) 795-4663
Mailing address
PO BOX 10069, SAN BERNARDINO, CA 92423-0069
(909) 335-4188
(909) 796-4158
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207N00000X
Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207W00000X
Ophthalmology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
01/31/2008
Last updated
09/30/2022
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