Healthcare Provider Details

I. General information

NPI: 1679646350
Provider Name (Legal Business Name): DAVID H BECK P.A.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 07/29/2024
Certification Date: 07/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6040 N 43RD AVE STE 1
GLENDALE AZ
85301-5481
US

IV. Provider business mailing address

3815 E BELL RD STE 4500
PHOENIX AZ
85032-2171
US

V. Phone/Fax

Practice location:
  • Phone: 623-931-2221
  • Fax: 623-934-2849
Mailing address:
  • Phone: 602-633-3848
  • Fax: 602-633-3841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number2288
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: