Healthcare Provider Details

I. General information

NPI: 1073527081
Provider Name (Legal Business Name): JAMES TODD BEATY D.P.M
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 11/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 PIRIE RD STE A
OJAI CA
93023-3100
US

IV. Provider business mailing address

115 PIRIE RD STE A
OJAI CA
93023-3100
US

V. Phone/Fax

Practice location:
  • Phone: 805-646-7163
  • Fax: 805-646-7164
Mailing address:
  • Phone: 805-646-7163
  • Fax: 805-646-7164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE4302
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: