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NPI Code Detail

MEDICARE: PARKER BEATTY DO

MEDICARE: PARKER BEATTY DO
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
1208D00000XGeneral Practice Physician0102208059VA
22083A0100XAerospace Medicine Physician0102208059VA

General Provider Information

NPI Number : 1528703998
Entity Type Code : Individual
Provider Name (Legal Business Name) : PARKER BEATTY DO
Provider Business Mailing Address
First Line : NMRTC
Second Line : 34800 BOB WILSON DRIVE
City : SAN DIEGO
State : CA
Zip : 92134-5000
Country : US
Telephone Number : 619-532-7522
Fax Number : 619-532-6941
Provider Business Practice Location Address
First Line : 34800 BOB WILSON DR
Second Line :
City : SAN DIEGO
State : CA
Zip : 92134-5000
Country : US
Telephone Number : 619-881-9011
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2022
Last Update Date : 06/19/2026

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Directions to “ PARKER BEATTY DO” Practice Location

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