Provider Demographics
NPI:1659610236
Name:BEYOND PHYSICAL MEDICINE AND REHABILITATION INC
Entity Type:Organization
Organization Name:BEYOND PHYSICAL MEDICINE AND REHABILITATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:916-792-2328
Mailing Address - Street 1:1106 WINDFIELD WAY STE 2
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-9360
Mailing Address - Country:US
Mailing Address - Phone:916-941-6500
Mailing Address - Fax:916-404-6022
Practice Address - Street 1:1106 WINDFIELD WAY STE 2
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-9360
Practice Address - Country:US
Practice Address - Phone:916-941-6500
Practice Address - Fax:916-404-6022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-02
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA71660207QS0010X
A71660332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6765700001OtherMEDICARE DME
CA6765700001OtherMEDICARE DME