Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | G21548 | CA |
NPI | 1588622484 |
---|---|
Provider Name | Dr. Clifford Sheldon Beck |
First Address | Bishop, CA 93514-2563 |
Second Address | Bishop, CA 93514-2563 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G215480 | (05) | CA |
A41312 | (02) | CA |