Basic Information
| Provider Information | |||||||||
| NPI: | 1922289289 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BEAU | ||||||||
| FirstName: | PAULA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1724 W 17TH ST | ||||||||
| Address2: | |||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927062317 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7145621769 | ||||||||
| FaxNumber: | 7145621773 | ||||||||
| Practice Location | |||||||||
| Address1: | 1725 W. 17TH STREET | ||||||||
| Address2: | |||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7148347763 | ||||||||
| FaxNumber: | 7148347977 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2007 | ||||||||
| LastUpdateDate: | 04/02/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 376299 | CA | Y | Nursing Service Providers | Registered Nurse |
No ID Information.