Provider Demographics
NPI:1467648345
Name:SCOTT W BEEVE MD INC
Entity Type:Organization
Organization Name:SCOTT W BEEVE MD INC
Other - Org Name:BEEVE VISION CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:BEEVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-790-8001
Mailing Address - Street 1:1809 VERDUGO BLVD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91208-1402
Mailing Address - Country:US
Mailing Address - Phone:818-790-8001
Mailing Address - Fax:818-790-7757
Practice Address - Street 1:1809 VERDUGO BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91208-1402
Practice Address - Country:US
Practice Address - Phone:818-790-8001
Practice Address - Fax:818-790-7757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207W00000X
CAA71788261QS0132X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
W14592OtherPALMETO
W14592OtherPALMETO GBA
W14592OtherPALMETO
W14592Medicare UPIN
CACH2032Medicare PIN