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NPI Code Detail

MEDICARE: BEYOND PHYSICAL MEDICINE AND REHABILITATION, INC

MEDICARE: BEYOND PHYSICAL MEDICINE AND REHABILITATION, INC
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
1332900000XNon-Pharmacy Dispensing Site

General Provider Information

NPI Number : 1225336126
Entity Type Code : Organization
Provider Name (Legal Business Name) : BEYOND PHYSICAL MEDICINE AND REHABILITATION, INC
Provider Business Mailing Address
First Line : 2980 N BEVERLY GLEN CIR
Second Line : SUITE 301
City : LOS ANGELES
State : CA
Zip : 90077-1726
Country : US
Telephone Number : 310-474-9809
Fax Number :
Provider Business Practice Location Address
First Line : 1106 WINDFIELD WAY
Second Line : SUITE 2
City : EL DORADO HILLS
State : CA
Zip : 95762-9360
Country : US
Telephone Number : 916-941-6500
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. GLENDA GOODWIN
Credential : M.D.
Telephone Number : 916-941-6500
Provider Enumeration Date : 03/02/2011
Last Update Date : 05/21/2013

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Directions to “BEYOND PHYSICAL MEDICINE AND REHABILITATION, INC ” Practice Location

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