MEDICARE: DR. JAMES TODD BEATY D.P.M

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	E4302	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073527081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES TODD BEATY D.P.M

Provider Business Mailing Address
First Line	:	115 PIRIE RD STE A
Second Line	:
City	:	OJAI
State	:	CA
Zip	:	93023-3100
Country	:	US
Telephone Number	:	805-646-7163
Fax Number	:	805-646-7164

Provider Business Practice Location Address
First Line	:	115 PIRIE RD STE A
Second Line	:
City	:	OJAI
State	:	CA
Zip	:	93023-3100
Country	:	US
Telephone Number	:	805-646-7163
Fax Number	:	805-646-7164

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	11/24/2009

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