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NPI Code Detail

MEDICARE: CALLISTA BECKER PA-C

MEDICARE: CALLISTA BECKER PA-C
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1902753973
Entity Type Code : Individual
Provider Name (Legal Business Name) : CALLISTA BECKER PA-C
Provider Business Mailing Address
First Line : 3100 N CENTRAL AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85012-2637
Country : US
Telephone Number : 602-812-4312
Fax Number :
Provider Business Practice Location Address
First Line : 3100 N CENTRAL AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85012-2637
Country : US
Telephone Number : 602-812-4312
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2026
Last Update Date : 03/11/2026

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Directions to “ CALLISTA BECKER PA-C” Practice Location

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