| NPI | 1528312089 |
|---|---|
| Doing Business As | BEAVER MEDICAL GROUP - PRIMARY CARE NORTH |
| Entity Type | Organization |
| Authorized Contact | KENNY HEINE VP Ops 858-964-1506 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: CA G58102) |
| Enumeration Date | 2012-11-06 |
| Last Update Date | 2012-11-06 |