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BEAVER MEDICAL GROUP - INTERNAL
NPI 1578991816
Non-Pharmacy Dispensing Site in Redlands, CA

Active since October 24, 2013
2 W FERN AVE, SUITE 200, REDLANDS, CA 92373(909) 793-3311 Get Directions Write a Review

NPPES record last updated: October 24, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Beaver Medical Group - Internal NPPES

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

BEAVER MEDICAL GROUP - INTERNAL (NPI 1578991816) is a healthcare organization registered as a non-pharmacy dispensing site in Redlands, California and active in the NPI registry since October 2013. The organization lists Kenny Heine, Vp Of Operations, as its authorized official.

NPPES Registry Identity

NPI1578991816
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameBEAVER MEDICAL GROUP LP
Location Address2 W FERN AVE, SUITE 200Redlands, CA 92373-5916
Mailing Address5626 Oberlin Dr, Suite 110San Diego, CA 92121-1705
Phone(909) 793-3311
Organization SubpartYesParent: Medvantx, Inc.
Authorized OfficialKenny HeineVp Of Operations · (858) 964-1506
Enumeration DateOctober 24, 2013
✔ NPI 1578991816 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
License✔ Licensed in CA · A96734
Definition
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
2 W FERN AVE, Redlands, CA 92373
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Other Names 1

Doing Business AsBeaver Medical Group - Internal

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.

CYNTHIA L PACHECO AGACNP
Nurse Practitioner (Acute Care)
2 W FERN AVE
REDLANDS, CA 92373
San Bernardino County (909) 793-3311
MRS. LISA C ANDERSON N.P.
Nurse Practitioner
2 W FERN AVE
REDLANDS, CA 92373
San Bernardino County (909) 793-3311
MR. LUIS A SANCHEZ DO
Anesthesiology
2 W FERN AVE
REDLANDS, CA 92373
San Bernardino County (909) 793-3311
MADISON TUCKER ZAGURSKI PA-C
Physician Assistant (Medical)
2 W FERN AVE
REDLANDS, CA 92373
San Bernardino County (909) 792-2605
DR. BRADLEY BASINGER M.D.
Surgery
2 W FERN AVE
REDLANDS, CA 92373
San Bernardino County (909) 793-3311
JOHN W MORTENSEN M.D.
Radiology (Diagnostic Radiology)
2 W FERN AVE
REDLANDS, CA 92373
San Bernardino County (909) 793-3311
NARMISHA VIJAY PATEL M.D
Hospitalist
2 W FERN AVE
REDLANDS, CA 92373
San Bernardino County (909) 583-2741
DR. KEVIN JAN CHAN MD
Hospitalist
2 W FERN AVE
REDLANDS, CA 92373
San Bernardino County (909) 793-3311

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 LP's NPI number?

The NPI number for Beaver Medical Group LP is 1578991816. It was assigned to this organization in the NPPES registry on October 24, 2013. The provider is doing business as Beaver Medical Group - Internal.

Where is Beaver Medical Group LP located?

Beaver Medical Group LP is located at 2 W Fern Ave Suite 200, Redlands, CA 92373. The listed phone number is (909) 793-3311.

What is Beaver Medical Group LP's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

When was this NPI record last updated?

The NPPES record for Beaver Medical Group LP was last updated on October 24, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.