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General NPI Number Information
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NPI Number | 1477960276
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Entity Type | Organization
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Legal Business Name | BECKER PEDIATRIC MEDICAL CORP.
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Dates
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Enumeration Date | 07/14/2014
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Last Update Date | 10/28/2016
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Provider Practice Location Address
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Address Line | 24679 MONROE AVE SUITE D102-103
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City | MURRIETA
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State | CA
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Zip | 92562
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Country | US
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Telephone | 951-600-2681
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Fax | 951-600-0131
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Provider Business Mailing Address
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Address Line | 24679 MONROE AVE SUITE D102-103
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City | MURRIETA
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State | CA
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Zip | 92562
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Country | US
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Telephone | 951-600-2681
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Fax | 951-600-0131
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Authorized Official
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Title or Position | MD-OWNER
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Name | DR. RONALD PAUL BECKER
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Credential | MD
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Telephone | 951-600-2681
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | G058254
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State | CA
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