Healthcare Provider Details

I. General information

NPI: 1700780053
Provider Name (Legal Business Name): CURTIS MICHAEL BECKMAN CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11812 SHADYCREST LN
LA HABRA CA
90631-3347
US

IV. Provider business mailing address

11812 SHADYCREST LN
LA HABRA CA
90631-3347
US

V. Phone/Fax

Practice location:
  • Phone: 562-743-7191
  • Fax:
Mailing address:
  • Phone: 562-743-7191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number95148730
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: