Healthcare Provider Details

I. General information

NPI: 1659610236
Provider Name (Legal Business Name): BEYOND PHYSICAL MEDICINE AND REHABILITATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2013
Last Update Date: 12/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1106 WINDFIELD WAY STE 2
EL DORADO HILLS CA
95762-9360
US

IV. Provider business mailing address

1106 WINDFIELD WAY STE 2
EL DORADO HILLS CA
95762-9360
US

V. Phone/Fax

Practice location:
  • Phone: 916-941-6500
  • Fax: 916-404-6022
Mailing address:
  • Phone: 916-941-6500
  • Fax: 916-404-6022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberA71660
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberA71660
License Number State

VIII. Authorized Official

Name: DR. DOUGLAS ROBERT MURRAY
Title or Position: PARTNER
Credential: D.C.
Phone: 916-792-2328