BEAVER MEDICAL GROUP, LP
NPI 1144265919
Optometrist in Colton, CA

Q: What is Beaver Medical Group, LP's NPI number?

The NPI number for Beaver Medical Group, LP is 1144265919. It was assigned to this organization in the NPPES registry on June 17, 2006.

Q: What is Beaver Medical Group, LP's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Active since June 17, 2006CLIA Certified · 7 labs

1300 E COOLEY DR, COLTON, CA 92324(909) 370-4100(909) 796-4158 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 20, 2024, Aug 22, 2020 (2 updates tracked since 2020).

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About Beaver Medical Group, Lp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BEAVER MEDICAL GROUP, LP (NPI 1144265919) is a healthcare organization registered as an optometrist in Colton, California and active in the NPI registry since June 2006. The organization holds 7 active CLIA laboratory certificates and lists Dennis P Flynn, Vice President Of Medical Affairs, as its authorized official.

NPPES Registry Identity

NPI1144265919

Entity TypeOrganization

Primary Taxonomy152W00000X

Legal Business NameBEAVER MEDICAL GROUP, LP

Location Address1300 E COOLEY DRColton, CA 92324-3905

Mailing AddressPo Box 2200Redlands, CA 92373-0722 · (909) 793-3311 · Fax (909) 796-4158

Phone(909) 370-4100

Fax(909) 796-4158

Organization SubpartNo

Authorized OfficialDennis P FlynnVice President Of Medical Affairs · (909) 799-1818

Enumeration DateJune 17, 2006

Last NPPES UpdateAugust 22, 20202 updates tracked since enumeration

✔ NPI 1144265919 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

Definition

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Also ListedFamily MedicineTaxonomy 207Q00000X

Also ListedInternal MedicineTaxonomy 207R00000X

Also ListedPediatricsTaxonomy 208000000X

1300 E COOLEY DR, Colton, CA 92324

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 7

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D0929914

Beaver Medical Group LP, Cooley Ranch Office · Colton, CA

Active · expires Jun 24, 2027

CLIA Number05D0929914

Laboratory TypeAncillary Testing Site In Health Care Center

Certificate Effective DateJune 25, 2025

Certificate Expiration DateJune 24, 2027

Laboratory DirectorKelvin Ma

Laboratory Phone(909) 786-0844

Laboratory LocationBeaver Medical Group LP, Cooley Ranch Office1300 E Cooley Drive, Colton, CA 92324

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Waiver 05D2258185

Beaver Medical Group, PC Ent Red · Redlands, CA

Active · expires Apr 17, 2028

CLIA Number05D2258185

Laboratory TypeAncillary Testing Site In Health Care Center

Certificate Effective DateApril 18, 2026

Certificate Expiration DateApril 17, 2028

Laboratory DirectorAlvin Umeda

Laboratory Phone(909) 786-0844

Laboratory LocationBeaver Medical Group, PC Ent Red259 Terracina Blvd, Redlands, CA 92373

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D1051242

Beaver Medical Group, L.P./Redlands · Redlands, CA

Active · expires Feb 26, 2028

CLIA Number05D1051242

Laboratory TypePhysician Office

Certificate Effective DateFebruary 27, 2026

Certificate Expiration DateFebruary 26, 2028

Laboratory DirectorStephen N. Hordynski

Laboratory Phone(909) 786-0844

Laboratory LocationBeaver Medical Group, L.P./Redlands2 W Fern Ave, Redlands, CA 92373

CLIA data matches this NPI record on: Name

Certificate of Waiver 05D2003151

Beaver Medical Group, LP Oasis Medical Plaza · Redlands, CA

Active · expires Feb 2, 2028

CLIA Number05D2003151

Laboratory TypePhysician Office

Certificate Effective DateFebruary 3, 2026

Certificate Expiration DateFebruary 2, 2028

Laboratory DirectorSteven O. Rimmer

Laboratory Phone(909) 786-0844

Laboratory LocationBeaver Medical Group, LP Oasis Medical Plaza1690 Barton Rd Ste 200, Redlands, CA 92373

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 05D2106963

Beaver Medical Group PC · Redlands, CA

Active · expires Oct 31, 2026

CLIA Number05D2106963

Laboratory TypePhysician Office

Certificate Effective DateNovember 1, 2024

Certificate Expiration DateOctober 31, 2026

Laboratory DirectorCharles H. Yoh

Laboratory Phone(909) 786-0844

Laboratory LocationBeaver Medical Group PC245 Terracina Blvd, Redlands, CA 92373

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D0675174

Beaver Medical Group LP Oasis Pediatrics · Redlands, CA

Active · expires Aug 31, 2026

CLIA Number05D0675174

Laboratory TypePhysician Office

Certificate Effective DateSeptember 1, 2024

Certificate Expiration DateAugust 31, 2026

Laboratory DirectorVaronica Dixon

Laboratory Phone(909) 786-0844

Laboratory LocationBeaver Medical Group LP Oasis Pediatrics1690 Barton Rd, Ste 104, Redlands, CA 92373

CLIA data matches this NPI record on: Name

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DEPATMENT OF BEHAVIORAL HEALTH

Special Hospital