Healthcare Provider Details

I. General information

NPI: 1619082401
Provider Name (Legal Business Name): HARVEY KIM BEAN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: H. KIM BEAN DPM

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 N CARSON ST
CARSON CITY NV
89701-1216
US

IV. Provider business mailing address

1801 N CARSON ST
CARSON CITY NV
89701-1216
US

V. Phone/Fax

Practice location:
  • Phone: 775-882-1441
  • Fax: 775-882-6844
Mailing address:
  • Phone: 775-882-1441
  • Fax: 775-882-6844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number25
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: