Provider Demographics
NPI:1578508545
Name:FOREHAND, LYLE BEVERLY JR (MD)
Entity Type:Individual
Prefix:DR
First Name:LYLE
Middle Name:BEVERLY
Last Name:FOREHAND
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14320 PALM DR
Mailing Address - Street 2:
Mailing Address - City:DESERT HOT SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92240-6874
Mailing Address - Country:US
Mailing Address - Phone:760-773-6767
Mailing Address - Fax:760-773-6760
Practice Address - Street 1:14320 PALM DRIVE
Practice Address - Street 2:
Practice Address - City:DESERT HOT SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92240
Practice Address - Country:US
Practice Address - Phone:760-773-6767
Practice Address - Fax:760-773-6760
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA791172084A0401X, 2084F0202X, 2084P0015X, 2084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
No2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5036Medicaid
00A791170Medicare ID - Type Unspecified
H79905Medicare UPIN