MEDICARE: JAMES BEACH D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	1438	AZ

General Provider Information

NPI Number	:	1053304808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES BEACH D.O.

Provider Business Mailing Address
First Line	:	7725 N 43RD AVE
Second Line	:	SUITE 111
City	:	PHOENIX
State	:	AZ
Zip	:	85051-5770
Country	:	US
Telephone Number	:	623-931-9201
Fax Number	:	623-931-2116

Provider Business Practice Location Address
First Line	:	7725 N 43RD AVE
Second Line	:	SUITE 111
City	:	PHOENIX
State	:	AZ
Zip	:	85051-5770
Country	:	US
Telephone Number	:	623-931-9201
Fax Number	:	623-931-2116

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2005
Last Update Date	:	10/29/2014

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Directions to “ JAMES BEACH D.O.” Practice Location

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