MEDICARE: DR. TIM NICO BECK MD, PHD

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	208600000X	Surgery Physician	A197438	CA

General Provider Information

NPI Number	:	1700381647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIM NICO BECK MD, PHD

Provider Business Mailing Address
First Line	:	3400 DATA DR
Second Line	:
City	:	RANCHO CORDOVA
State	:	CA
Zip	:	95670-7956
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3838 SAN DIMAS ST STE A100
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93301-2286
Country	:	US
Telephone Number	:	661-327-8538
Fax Number	:	661-327-5432

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

Provider Enumeration Date	:	03/23/2018
Last Update Date	:	01/07/2025

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