Provider Demographics
NPI:1841283520
Name:DONALD J BEILSTEIN OD APC
Entity type:Organization
Organization Name:DONALD J BEILSTEIN OD APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:BEILSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:530-432-2020
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-26
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7416T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0074160Medicaid
CA4556430001Medicare NSC
CASD0074160Medicaid