Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | DC-29914 | CA |
NPI | 1588790653 |
---|---|
Provider Name | Dr. Julie M Beck |
First Address | Tarzana, CA 91356-4103 |
Second Address | Tehachapi, CA 93561-7977 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2007 |
Last Update Date | 14/01/2014 |