Healthcare Provider Details

I. General information

NPI: 1700996915
Provider Name (Legal Business Name): DONALD B. BEAMON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 E 7TH ST # 114
LONG BEACH CA
90822-5201
US

IV. Provider business mailing address

5901 E 7TH ST # 114
LONG BEACH CA
90822-5201
US

V. Phone/Fax

Practice location:
  • Phone: 888-771-8387
  • Fax: 562-826-5425
Mailing address:
  • Phone: 888-771-8387
  • Fax: 562-826-5425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Internal Medicine Physician
License NumberG 17112
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberG 17112
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License NumberG17112
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License NumberG 17112
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License NumberG 17112
License Number StateCA
# 6
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberG 17112
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberG 17112
License Number StateCA
# 8
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License NumberG 17112
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: