Healthcare Provider Details

I. General information

NPI: 1497992358
Provider Name (Legal Business Name): ANA ELIZABETH BELTRAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2009
Last Update Date: 03/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

279 E ARROW HWY
SAN DIMAS CA
91773-3319
US

IV. Provider business mailing address

233 S QUINTANA DR
ANAHEIM CA
92807-4029
US

V. Phone/Fax

Practice location:
  • Phone: 909-260-6355
  • Fax:
Mailing address:
  • Phone: 714-988-9822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: