Provider Demographics
NPI:1417919770
Name:BEALE, PAUL (CSFA)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:BEALE
Suffix:
Gender:M
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2251 S ZANG CT
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-4365
Mailing Address - Country:US
Mailing Address - Phone:720-335-5701
Mailing Address - Fax:
Practice Address - Street 1:2251 S ZANG CT
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-4365
Practice Address - Country:US
Practice Address - Phone:303-716-5738
Practice Address - Fax:303-716-9024
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSA.0001073246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant