Provider Demographics
NPI:1619141058
Name:BEILSTEIN, DONALD JAMES (OD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:JAMES
Last Name:BEILSTEIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11250 PLEASANT VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:PENN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95946-9413
Mailing Address - Country:US
Mailing Address - Phone:530-432-2020
Mailing Address - Fax:530-432-7666
Practice Address - Street 1:11250 PLEASANT VALLEY RD
Practice Address - Street 2:
Practice Address - City:PENN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95946-9413
Practice Address - Country:US
Practice Address - Phone:530-432-2020
Practice Address - Fax:530-432-7666
Is Sole Proprietor?:No
Enumeration Date:2008-04-16
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7416-T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T10532Medicare UPIN