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Beaver Medical Group Lp — NPI 1881857597, Banning, CA | NPI Central

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NPI 1881857597

OrganizationActive

Beaver Medical Group Lp

NPI 1881857597 · Non-Pharmacy Dispensing Site · Banning, CA

Provider details

NPI number: 1881857597
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: C51632 (CA)

Specialties & taxonomies

Non-Pharmacy Dispensing SitePrimary332900000XLicense C51632 (CA)
Suppliers

Practice location

6109 W Ramsey St

Banning, CA 92220-3051

Phone: (951) 845-0313

Approximate (ZIP-level) locationGet directions

More CA providers

Mailing address

5626 Oberlin Dr

San Diego, CA 92121-1705

Other names (DBA / former)

Doing business as: Beaver Medical Group - Banning Extended Care

Registry dates

Enumerated: 2008-07-03
Last updated: 2013-04-25

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