Organization
BEAVER MEDICAL GROUP, L.P.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES PAYTON M.D. (VICE PRESIDENT/CHIEF MEDICAL OFFICE)
(909) 478-5162
Entity
Organization
Contact information
Practice address
245 TERRACINA BLVD., STE. 209, REDLANDS, CA 92373-4865
(909) 793-3311
(909) 307-6567
Mailing address
PO BOX 2200, REDLANDS, CA 92373-0722
(909) 335-4148
(909) 793-2916
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
11/28/2012
Last updated
11/28/2012
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