MEDICARE: DR. TIFFANY MERRILL BECKER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	A067392	CA

General Provider Information

NPI Number	:	1275634511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIFFANY MERRILL BECKER M.D.

Provider Business Mailing Address
First Line	:	56 BUCKSKIN LN
Second Line	:
City	:	ROLLING HILLS ESTATES
State	:	CA
Zip	:	90274-4205
Country	:	US
Telephone Number	:	310-325-3233
Fax Number	:

Provider Business Practice Location Address
First Line	:	827 DEEP VALLEY DR
Second Line	:	SUITE 201
City	:	ROLLING HILLS ESTATES
State	:	CA
Zip	:	90274-3647
Country	:	US
Telephone Number	:	310-541-5400
Fax Number	:	310-541-5466

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	06/22/2012

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