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Beaver Medical Group Lp — NPI 1639344716, Highland, CA | NPI Central

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NPI 1639344716

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Beaver Medical Group Lp

NPI 1639344716 · Non-Pharmacy Dispensing Site · Highland, CA

Provider details

NPI number: 1639344716
Entity type: Organization
Primary specialty: Non-Pharmacy Dispensing SiteSuppliers
Parent organization: Medvantx, Inc.
Organization subpart: Yes
Authorized official: Kenny Heine, Vp of Operations(858) 625-2990
License: A69210 (CA)

Specialties & taxonomies

Non-Pharmacy Dispensing SitePrimary332900000XLicense A69210 (CA)
Suppliers

Practice location

7000 Boulder Ave

Highland, CA 92346-3348

Phone: (909) 862-1191

Approximate (ZIP-level) locationGet directions

More CA providers

Mailing address

9276 Scranton Rd

San Diego, CA 92121-7701

Other names (DBA / former)

Doing business as: Beaver Medical Group - Highland Extended Care

Registry dates

Enumerated: 2008-04-29
Last updated: 2016-06-09

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.