Organization
BEAVER MEDICAL GROUP P C
Active
Parent organization
BEAVER MEDICAL GROUP P C
Organization subpart
Yes
Provider details
NPI number
Legal business name
BEAVER MEDICAL GROUP P C
Authorized official
EMILY CASTILLO (ASSOCIATE DIRECTOR)
(702) 480-2550
Entity
Organization
Contact information
Practice address
1690 BARTON ROAD, REDLANDS, CA 92373-4231
(909) 793-3311
(909) 335-4111
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 579-3203
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
11/15/2012
Last updated
04/02/2025
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