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NPI Code Detail

MEDICARE: MRS. CARLY BEUKMAN

MEDICARE: MRS. CARLY BEUKMAN
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
1225100000XPhysical Therapist42788CA
2225100000XPhysical TherapistPTL.0016814CO

General Provider Information

NPI Number : 1417325903
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CARLY BEUKMAN
Provider Business Mailing Address
First Line : 7941 BEACH BLVD STE J
Second Line :
City : BUENA PARK
State : CA
Zip : 90620-1900
Country : US
Telephone Number : 714-736-6855
Fax Number :
Provider Business Practice Location Address
First Line : 7941 BEACH BLVD STE J
Second Line :
City : BUENA PARK
State : CA
Zip : 90620-1900
Country : US
Telephone Number : 714-736-6855
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2015
Last Update Date : 07/13/2021

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Directions to “ MRS. CARLY BEUKMAN ” Practice Location

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