MEDICARE: STEVEN ALAN BEALS CRNA

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	367500000X	Certified Registered Nurse Anesthetist	1814	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RN4733490	OTHER	CA	MEDI-CAL

General Provider Information

NPI Number	:	1548372899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN ALAN BEALS CRNA

Provider Business Mailing Address
First Line	:	2321 PROMONTORY DR
Second Line	:
City	:	SIGNAL HILL
State	:	CA
Zip	:	90755-3860
Country	:	US
Telephone Number	:	562-810-2100
Fax Number	:

Provider Business Practice Location Address
First Line	:	2321 PROMONTORY DR
Second Line	:
City	:	SIGNAL HILL
State	:	CA
Zip	:	90755-3860
Country	:	US
Telephone Number	:	562-810-2100
Fax Number	:

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	03/24/2015

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