MEDICARE: BEYOND PHYSICAL MEDICINE AND REHABILITATION INC

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	332B00000X	Durable Medical Equipment & Medical Supplies	A71660
2	207QS0010X	Sports Medicine (Family Medicine) Physician	A71660	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6765700001	OTHER	CA	MEDICARE DME

General Provider Information

NPI Number	:	1659610236
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEYOND PHYSICAL MEDICINE AND REHABILITATION INC

Provider Business Mailing Address
First Line	:	1106 WINDFIELD WAY STE 2
Second Line	:
City	:	EL DORADO HILLS
State	:	CA
Zip	:	95762-9360
Country	:	US
Telephone Number	:	916-941-6500
Fax Number	:	916-404-6022

Provider Business Practice Location Address
First Line	:	1106 WINDFIELD WAY STE 2
Second Line	:
City	:	EL DORADO HILLS
State	:	CA
Zip	:	95762-9360
Country	:	US
Telephone Number	:	916-941-6500
Fax Number	:	916-404-6022

Authorized Official
Title or Position	:	PARTNER
Name	:	DR. DOUGLAS ROBERT MURRAY
Credential	:	D.C.
Telephone Number	:	916-792-2328

Provider Enumeration Date	:	02/02/2013
Last Update Date	:	12/10/2013

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