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General NPI Number Information
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NPI Number | 1780232850
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Entity Type | Organization
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Legal Business Name | ELIZABETH C. BEAL, D.O., A PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 08/30/2019
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Last Update Date | 07/20/2021
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Provider Practice Location Address
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Address Line | 200 S MAIN ST STE D
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City | TEMPLETON
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State | CA
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Zip | 93465-9366
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Country | US
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Telephone | 805-670-2180
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Fax | 805-273-0298
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Provider Business Mailing Address
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Address Line | 200 S MAIN ST STE D
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City | TEMPLETON
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State | CA
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Zip | 93465-9366
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Country | US
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Telephone | 805-670-2180
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Fax | 805-273-0298
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Authorized Official
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Title or Position | PRESIDENT, MEDICAL DIRECTOR
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Name | ELIZABETH CLAUDIA HOPKIRK BEAL
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Credential | DO
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Telephone | 510-529-5825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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