Healthcare Provider Details

I. General information

NPI: 1306373949
Provider Name (Legal Business Name): THOMAS BEYER RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2017
Last Update Date: 05/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29610 RANCHO CALIFORNIA RD
TEMECULA CA
92591-5283
US

IV. Provider business mailing address

30429 STARGAZER WAY
MURRIETA CA
92563-6815
US

V. Phone/Fax

Practice location:
  • Phone: 951-699-0192
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number053631
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: