BEAVER MEDICAL GROUP, LP (NPI# 1619914959) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619914959 |
| Entity Type | Organization |
| Organization Name | BEAVER MEDICAL GROUP, LP |
| Practice Address |
6109 W Ramsey St Banning CA 92220-3051 |
| Mailing Address |
Po Box 10069 San Bernardino CA 92423-0069 |
| Practice Telephone | 9518450313 |
| Practice Fax Number | 9097964158 |
| Mailing Telephone | 9093354188 |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2020-02-19 |
| NPI Deactivation Date | 09/10/2009 |
| NPI Reactivation Date | 2012-11-09 |
| Authorized Official Name | CHARLES T CHEN (SENIOR MEDICAL DIRECTOR) |
| Authorized Official Telephone | 9097933311 |
| Is Organization Subpart | Y |
| Parent Organization Name | BEAVER MEDICAL GROUP, LP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | Eye and Vision Services Providers | ||
| N | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208800000X | Urology | Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326085663 | Beaver Medical Group, Lp | Orthopaedic Surgery | 259 Terracina Blvd, Redlands, CA 92373-4847 | 2006-06-02 |
| 1457372179 | Beaver Medical Group, Lp | Family Medicine | 5957 W Ramsey St, Banning, CA 92220-3058 | 2006-07-21 |
| 1346278363 | Beaver Medical Group, Lp | Internal Medicine | 7223 Church St, Ste C, Highland, CA 92346-5869 | 2006-06-29 |
| 1144265919 | Beaver Medical Group, Lp | Optometrist | 1300 E Cooley Dr, Colton, CA 92324-3905 | 2006-06-17 |
| 1831133768 | Beaver Medical Group, Lp | Allergy & Immunology | 2 W Fern Ave, Redlands, CA 92373-5916 | 2006-06-14 |
| 1427090281 | Beaver Medical Group, Lp | Physical Therapist | 245 Terracina Blvd, Suite # 105, Redlands, CA 92373-4852 | 2006-06-13 |
| 1598706293 | Beaver Medical Group, Lp | Dermatology | 7000 Boulder Ave, Highland, CA 92346-3348 | 2006-06-10 |
| 1275570830 | Beaver Medical Group, Lp | Internal Medicine | 1600 E Citrus Ave, Suite # A, Redlands, CA 92374-4270 | 2006-06-01 |
| Street Address |
6109 W RAMSEY ST |
| City | BANNING |
| State | CA |
| Zip Code | 92220-3051 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952305294 | Steven W Hildebrand | Internal Medicine | 6109 W Ramsey St, Banning, CA 92220-3051 | 2005-06-01 |
| 1134609415 | Carri Ranie Lakes | Registered Nurse | 6109 W Ramsey St, Banning, CA 92220-3051 | 2018-08-16 |
| 1316331838 | Yi Heng | Registered Nurse | 6109 W Ramsey St, Banning, CA 92220-3051 | 2015-03-23 |
| 1316365521 | Brandon Decaluwe | Ophthalmology | 6109 W Ramsey St, Banning, CA 92220-3051 | 2014-04-03 |
| 1962834499 | Stephanie Salazar | Nurse Practitioner | 6109 W Ramsey St, Banning, CA 92220-3051 | 2013-08-07 |
| 1902151277 | Julie Smits | Registered Nurse | 6109 W Ramsey St, Banning, CA 92220-3051 | 2012-07-23 |
| 1326356908 | Kelly Marie Stormes | Nurse Practitioner | 6109 W Ramsey St, Banning, CA 92220-3051 | 2010-09-17 |
| 1801129341 | Kaunteya Reddy | Internal Medicine | 6109 W Ramsey St, Banning, CA 92220-3051 | 2009-09-16 |
| 1487896783 | Craig Andre Seheult | Internal Medicine | 6109 W Ramsey St, Banning, CA 92220 | 2009-04-01 |
| 1881857597 | Beaver Medical Group Lp | Non-Pharmacy Dispensing Site | 6109 W Ramsey St, Banning, CA 92220-3051 | 2008-07-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962056523 | Golden View Guest Home, Inc. | Assisted Living Facility | 5466 West Wilson, Banning, CA 92220 | 2019-07-31 |
| 1780246157 | Fjs Hearing Professionals | Hearing Instrument Specialist | 3559 W Ramsey Ave Suit C-2, Banning, CA 92220 | 2019-07-05 |
| 1790237832 | Jennifer De Geus | Counselor | 1627 Hargrave St., Banning, CA 92220 | 2016-10-25 |
| 1427447507 | Dalonna Blackwell | Counselor | 2781 W. Ramsey St., Banning, CA 92220 | 2015-01-13 |
| 1639575962 | Eunjung J. Jung Choi | Dentist | 300 S Highland Springs Ave Ste 2l, Banning, CA 92220 | 2014-11-13 |
| 1861810244 | Genevra Diana Glenn | Counselor | 2781 W Ramsey, Suite 1, Banning, CA 92220 | 2014-04-02 |
| 1841617420 | Kristen Lew | Internal Medicine | 6109 W.ramsey Street, Banning, CA 92220 | 2014-03-21 |
| 1588917884 | Jamison William Murphy | Military Health Care Provider | Uss Howard Ddg 83, Fpo, AP 92220 | 2012-10-24 |
| 1972871390 | John Hong | Pharmacist | 60 N Highlandsprings, Beaumont, CA 92220 | 2011-12-13 |
| 1679855936 | Lydia Session | Marriage & Family Therapist | 1627 S. Hargrave, Banning, CA 92220 | 2011-09-13 |
| Find all providers in zip 92220 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841617420 | Kristen Lew | Internal Medicine | 6109 W.ramsey Street, Banning, CA 92220 | 2014-03-21 |
| 1255345138 | Muhammad Saleem Akhtar | Internal Medicine | 1034 W Ramsey St, # A, Banning, CA 92220-4442 | 2006-07-28 |
| 1770574154 | County of Riverside-community Health Agency | Internal Medicine | 3055 W Ramsey St, Banning, CA 92220-3781 | 2005-11-03 |
| 1083908396 | Ehsan Ghetmiri | Internal Medicine | 600 N Highland Springs Ave, Banning, CA 92220 | 2011-06-03 |
| 1447564513 | Hong Vo | Internal Medicine | 5957 W Ramsey St, Banning, CA 92220-3058 | 2010-08-01 |
| 1487896783 | Craig Andre Seheult | Internal Medicine | 6109 W Ramsey St, Banning, CA 92220 | 2009-04-01 |
| 1912180233 | Bahij Ghazal | Internal Medicine | 6109 W Ramsey St, Banning, CA 92220-3051 | 2007-12-10 |
| 1528277688 | Michael Joe Lee | Internal Medicine | 1169 W Ramsey St, Banning, CA 92220-4443 | 2007-05-22 |
| 1598881229 | Nawazish Shahdin Qazi | Internal Medicine | 264 N Highland Springs Ave, Suite 2a, Banning, CA 92220-3082 | 2007-03-22 |
| 1215052873 | Michael Tan Oliverio | Internal Medicine | 330 W Ramsey St, Banning, CA 92220-4823 | 2007-03-20 |
| Find all providers in BANNING | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.