Provider Demographics
NPI:1124186929
Name:BEEMAN, C. SPENCER (PT)
Entity type:Individual
Prefix:MR
First Name:C.
Middle Name:SPENCER
Last Name:BEEMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 784
Mailing Address - Street 2:
Mailing Address - City:BLUE JAY
Mailing Address - State:CA
Mailing Address - Zip Code:92317-0784
Mailing Address - Country:US
Mailing Address - Phone:909-336-7569
Mailing Address - Fax:
Practice Address - Street 1:26571 ST. HWY. 18
Practice Address - Street 2:SUITE B
Practice Address - City:RIMFOREST
Practice Address - State:CA
Practice Address - Zip Code:92378-0010
Practice Address - Country:US
Practice Address - Phone:909-337-4192
Practice Address - Fax:909-336-1982
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 204225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist