Organization
SCOTT A. BEASLEY, M.D., INC.
Active
Other names
California Neonatology Services Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KARA NORDBERG (ACCOUNTS ADMINISTRATOR)
(949) 492-3514
Entity
Organization
Contact information
Practice address
1401 S GRAND AVE, LOS ANGELES, CA 90015-3010
(213) 742-5716
(949) 366-2390
Mailing address
PO BOX 1359, SAN CLEMENTE, CA 92674-1359
(949) 492-3514
(949) 366-2390
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0057610
—
CA
Enumeration date
12/04/2006
Last updated
06/11/2008
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