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General NPI Number Information
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NPI Number | 1548086564
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Entity Type | Individual
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Provider Name | WHITMAN BEITEL
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Gender | Male
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Dates
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Enumeration Date | 11/25/2024
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 22 N 6TH ST
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City | REDLANDS
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State | CA
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Zip | 92373-5226
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Country | US
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Telephone | 909-855-8562
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Fax |
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Provider Business Mailing Address
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Address Line | 55 ORANGEWOOD CT
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City | REDLANDS
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State | CA
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Zip | 92373-1442
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Country | US
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Telephone | 909-855-8562
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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 | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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