Healthcare Provider Details

I. General information

NPI: 1417652355
Provider Name (Legal Business Name): BECKER CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2023
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 N SAN MATEO DR STE B
SAN MATEO CA
94401-2690
US

IV. Provider business mailing address

212 N SAN MATEO DR STE B
SAN MATEO CA
94401-2690
US

V. Phone/Fax

Practice location:
  • Phone: 650-340-1110
  • Fax: 650-340-1115
Mailing address:
  • Phone: 650-340-1110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. GREGORY WILLIAM BECKER
Title or Position: OWNER
Credential: DC
Phone: 650-340-1110