# BEAVER MEDICAL GROUP, LP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326085663
- **Authorized official:** CHARLES T CHEN (SENIOR MEDICAL DIRECTOR)
- **Authorized official phone:** (909) 793-3311

## Contact information

- **Practice address:** 259 TERRACINA BLVD, REDLANDS, CA 92373-4847
- **Practice address phone:** (909) 793-2634
- **Practice address fax:** (909) 796-4158
- **Mailing address:** PO BOX 10069, SAN BERNARDINO, CA 92423-0069
- **Mailing address phone:** (909) 335-4188

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/02/2006
- **Last updated:** 02/19/2020