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BEAVER MEDICAL GROUP PC
NPI 1205013323
Family Medicine in Yucaipa, CA

Active since January 31, 2008CLIA 05D0929913 · Microscopy
33758 YUCAIPA BLVD, YUCAIPA, CA 92399(909) 795-9747(909) 795-4663 Get Directions Write a Review

NPPES record last updated: September 30, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Beaver Medical Group Pc NPPES

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

BEAVER MEDICAL GROUP PC (NPI 1205013323) is a healthcare organization registered as a family medicine in Yucaipa, California and active in the NPI registry since January 2008. The organization holds a CLIA Microscopy certificate valid through June 24, 2027 and lists Charles Chen, Chief Medical Officer, as its authorized official.

NPPES Registry Identity

NPI1205013323
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameBEAVER MEDICAL GROUP PC
Location Address33758 YUCAIPA BLVDYucaipa, CA 92399-2243
Mailing AddressPo Box 10069San Bernardino, CA 92423-0069 · (909) 335-4188 · Fax (909) 796-4158
Phone(909) 795-9747
Fax(909) 795-4663
Organization SubpartNo
Authorized OfficialCharles ChenChief Medical Officer · (909) 793-3311
Enumeration DateJanuary 31, 2008
Last NPPES UpdateSeptember 30, 2022
NPPES CertifiedSeptember 30, 2022
✔ NPI 1205013323 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 7

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedOptometristTaxonomy 152W00000X
Also ListedDermatologyTaxonomy 207N00000X
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedOphthalmologyTaxonomy 207W00000X
Also ListedOrthopaedic SurgeryTaxonomy 207X00000X
Also ListedPediatricsTaxonomy 208000000X
33758 YUCAIPA BLVD, Yucaipa, CA 92399
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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

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) 05D0929913

Beaver Medical Group Yucaipa LP · Yucaipa, CA
Active · expires Jun 24, 2027
CLIA Number05D0929913
Laboratory TypeCommunity Clinic
Certificate Effective DateJune 25, 2025
Certificate Expiration DateJune 24, 2027
Laboratory DirectorScott James Ditch
Laboratory Phone(562) 988-7027
Laboratory LocationBeaver Medical Group Yucaipa LP33758 Yucaipa Blvd, Yucaipa, CA 92399
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.

Medical Equipment Supplier Medicare DMEPOS 16

Medicare supplier enrollment and the product categories Beaver Medical Group, PC carries, from the Medicare DMEPOS supplier directory.

Beaver Medical Group, PC

DMEPOS supplier · Yucaipa, CA
✔

Accepts Medicare assignment

Beaver Medical Group, PC agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20669921
Medicare Participant SinceAugust 17, 1994
Supplier Location33758 Yucaipa BlvdYucaipa, CA 92399
Phone(909) 795-9747
Provider TypePhysician – General Practice)
Supplier Specialties
Optometrist

Medicare Product Categories

Contracture Treatment Devices: Dynamic Splint
Dynamic splinting devices for the knee, elbow, wrist, finger, or toe
Heat & Cold Applications
Heat therapy, Cold therapy, Heating pads
Negative Pressure Wound Therapy Pumps/Supplies
Wound care sets, Pumps, Canisters
Traction Equipment
Traction tables, Traction machines, Inversion tables
Canes and/or Crutches
Standard Canes, Quad Canes, Offset Canes, Standard Crutches, Forearm Crutches
Orthoses: Custom Fabricated
Custom met pads, Custom heel pads, Custom heel spur pads
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

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.

TONYA ANN YONEY DO
Family Medicine
33758 YUCAIPA BLVD
YUCAIPA, CA 92399
San Bernardino County (909) 795-9747
EDGAR RICARDO RAMOS MALDONADO MD
Family Medicine
33758 YUCAIPA BLVD
YUCAIPA, CA 92399
San Bernardino County (909) 795-9747
SUZANNE CHARLOTTE MOORE NP
Nurse Practitioner (Family)
33758 YUCAIPA BLVD
YUCAIPA, CA 92399
San Bernardino County (909) 795-9747
DR. TERI T BOON M.D.
Family Medicine
33758 YUCAIPA BLVD
YUCAIPA, CA 92399
San Bernardino County (909) 797-9747
DR. RICHARD D DOTY M.D.
Dermatology
33758 YUCAIPA BLVD
YUCAIPA, CA 92399
San Bernardino County (909) 795-9747
EMMELINE R PULIDO M.D.
Pediatrics
33758 YUCAIPA BLVD
YUCAIPA, CA 92399
San Bernardino County (909) 795-9747
MEDAMERICA PHYSICIAN SOLUTIONS PC
General Practice
33758 YUCAIPA BLVD
YUCAIPA, CA 92399
San Bernardino County (909) 795-9747
MI LA KIM FNP
Nurse Practitioner (Family)
33758 YUCAIPA BLVD
YUCAIPA, CA 92399
San Bernardino County (909) 795-9747

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Beaver Medical Group PC's NPI number?

The NPI number for Beaver Medical Group PC is 1205013323. It was assigned to this organization in the NPPES registry on January 31, 2008.

Where is Beaver Medical Group PC located?

Beaver Medical Group PC is located at 33758 Yucaipa Blvd, Yucaipa, CA 92399. The listed phone number is (909) 795-9747.

What is Beaver Medical Group PC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Beaver Medical Group PC accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Beaver Medical Group, PC accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Beaver Medical Group PC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 05D0929913) is associated with this NPI, valid through June 24, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Beaver Medical Group PC was last updated on September 30, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.