Organization
BEAVER MEDICAL GROUP P C
Active
Other names
Beaver Advantage Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY CASTILLO (ASSOCIATE DIRECTOR)
(702) 480-2550
Entity
Organization
Contact information
Practice address
1600 E CITRUS AVE, SUITE # A, REDLANDS, CA 92374-4270
(909) 794-3682
(909) 796-4158
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 480-2550
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
06/01/2006
Last updated
08/20/2024
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