Provider Demographics
NPI:1295804698
Name:BETH ARY MD INC
Entity type:Organization
Organization Name:BETH ARY MD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR & CHIEF OF MEDICAL
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:ARY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-640-7200
Mailing Address - Street 1:1441 AVOCADO AVE #203
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660
Mailing Address - Country:US
Mailing Address - Phone:949-640-7200
Mailing Address - Fax:949-720-0203
Practice Address - Street 1:1441 AVOCADO AVE #203
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660
Practice Address - Country:US
Practice Address - Phone:949-640-7200
Practice Address - Fax:949-720-0203
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BETH ARY MD INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-07
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG40599261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical