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General NPI Number Information
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NPI Number | 1164588463
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Entity Type | Individual
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Provider Name | BEVERLY MORGAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2233 GRAND CANAL BLVD STE 105
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City | STOCKTON
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State | CA
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Zip | 95207-8117
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Country | US
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Telephone | 209-953-3611
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Fax |
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Provider Business Mailing Address
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Address Line | 4884 LOWREY RD
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City | OAKLAND
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State | CA
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Zip | 94605-5726
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Country | US
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Telephone | 510-638-3270
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A22426
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License Number State | CA
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