MEDICARE: BEATON ORTHOPEDIC PHYSICAL THERAPY

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	273Y00000X	Rehabilitation Hospital Unit	14525	CA

General Provider Information

NPI Number	:	1770892325
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEATON ORTHOPEDIC PHYSICAL THERAPY

Provider Business Mailing Address
First Line	:	24955 PACIFIC COAST HIGHWAY C-102
Second Line	:
City	:	MALIBU
State	:	CA
Zip	:	90265
Country	:	US
Telephone Number	:	310-456-9332
Fax Number	:	310-456-5868

Provider Business Practice Location Address
First Line	:	24955 PACIFIC COAST HWY STE C102
Second Line	:
City	:	MALIBU
State	:	CA
Zip	:	90265-4749
Country	:	US
Telephone Number	:	310-456-9332
Fax Number	:	310-456-5868

Authorized Official
Title or Position	:	OWNER
Name	:	MR. GREGORY STEVENS BEATON
Credential	:	P.T. O.C.S
Telephone Number	:	310-456-9332

Provider Enumeration Date	:	09/30/2010
Last Update Date	:	06/16/2016

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Directions to “BEATON ORTHOPEDIC PHYSICAL THERAPY ” Practice Location

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