Organization
BEAVER MEDICAL GROUP P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY CASTILLO (ASSOCIATE DIRECTOR)
(702) 480-2550
Entity
Organization
Contact information
Practice address
245 TERRACINA BLVD., STE. 102, REDLANDS, CA 92373-4865
(909) 792-2605
(909) 307-6566
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 480-2550
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
11/28/2012
Last updated
08/20/2024
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