Healthcare Provider Details

I. General information

NPI: 1275947020
Provider Name (Legal Business Name): DR. J. D. BECKES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2014
Last Update Date: 06/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 E 4TH ST
NATIONAL CITY CA
91950-2026
US

IV. Provider business mailing address

2710 ALPINE BLVD SUITE O-244
ALPINE CA
91901-2276
US

V. Phone/Fax

Practice location:
  • Phone: 619-472-4690
  • Fax: 619-472-4699
Mailing address:
  • Phone: 619-985-0532
  • Fax: 888-939-4201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number20A6973
License Number StateCA

VIII. Authorized Official

Name: DR. JOHN D BECKES
Title or Position: CEO
Credential: D.O., PH.D.
Phone: 619-985-0532