Healthcare Provider Details

I. General information

NPI: 1124000724
Provider Name (Legal Business Name): RONALD P BECKER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 08/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41011 CALIFORNIA OAKS RD SUITE 101
MURRIETA CA
92562-5751
US

IV. Provider business mailing address

41011 CALIFORNIA OAKS RD SUITE 101
MURRIETA CA
92562-5751
US

V. Phone/Fax

Practice location:
  • Phone: 951-600-2681
  • Fax: 951-600-0131
Mailing address:
  • Phone: 951-600-2681
  • Fax: 951-600-0131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG58254
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: