Individual
BRENT W BEAHM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1400 E CHURCH ST, SANTA MARIA, CA 93454-5906
(805) 434-4989
(808) 434-0721
Mailing address
PO BOX 1510, TEMPLETON, CA 93465-1510
(805) 434-4989
(805) 434-0721
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A34129
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A341290
—
CA
Enumeration date
03/19/2007
Last updated
07/08/2007
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