MEDICARE: BEVERLY ESTES MD

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	208000000X	Pediatrics Physician	G19892	CA

General Provider Information

NPI Number	:	1851351795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEVERLY ESTES MD

Provider Business Mailing Address
First Line	:	11875 DUBLIN BLVD
Second Line	:	SUITE B 125
City	:	DUBLIN
State	:	CA
Zip	:	94568-2843
Country	:	US
Telephone Number	:	925-587-2505
Fax Number	:	925-587-2511

Provider Business Practice Location Address
First Line	:	2160 APPIAN WAY
Second Line	:	SUITE 100
City	:	PINOLE
State	:	CA
Zip	:	94564-2524
Country	:	US
Telephone Number	:	510-724-8300
Fax Number	:	510-724-8391

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

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	10/17/2012

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Directions to “ BEVERLY ESTES MD” Practice Location

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