# CLISTO D BEATY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1891806162
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 169252-1205 | UT | Yes |
| 207L00000X | Anesthesiology Physician | M-4600 | ID | — |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 07/08/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 107006158102 | IHC | UT |
| 01 | — | 36319 | DESERET MUTUAL | UT |
| 01 | — | 51728 | HEALTHY U | UT |
| 01 | — | 7820 | PEHP | UT |
| 01 | — | 870525882BE1 | EDUCATORS MUTUAL | UT |
| 01 | — | PR00524 | MOLINA | UT |
| 01 | — | QM0000076595 | ALTIUS | UT |