Provider Demographics
NPI:1396898342
Name:BEACH, DEE JAY (DO)
Entity type:Individual
Prefix:
First Name:DEE JAY
Middle Name:
Last Name:BEACH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8515 PEARL ST STE 300
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229-4809
Mailing Address - Country:US
Mailing Address - Phone:303-853-8989
Mailing Address - Fax:
Practice Address - Street 1:8515 PEARL ST STE 300
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4809
Practice Address - Country:US
Practice Address - Phone:303-853-8989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO294882083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine