Healthcare Provider Details

I. General information

NPI: 1750509139
Provider Name (Legal Business Name): DR. DAVID PAUL BEILSTEIN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DAVID P BEILSTEIN DPM

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 LARKFIELD CTR # 271
SANTA ROSA CA
95403-1408
US

IV. Provider business mailing address

422 LARKFIELD CTR # 271
SANTA ROSA CA
95403-1408
US

V. Phone/Fax

Practice location:
  • Phone: 707-578-5599
  • Fax:
Mailing address:
  • Phone: 707-578-5599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberE2809
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: