Healthcare Provider Details

I. General information

NPI: 1639118912
Provider Name (Legal Business Name): JOHN D. BECKES D.O., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 12/21/2025
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: 619-472-4390
  • Fax: 619-472-4699
Mailing address:
  • Phone: 619-985-0532
  • Fax: 619-752-3979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number20A6973
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: