Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | 31352 | CA |
NPI | 1518264456 |
---|---|
Provider Name | Dr. Tina Ann Beck |
First Address | Fullerton, CA 92835-2000 |
Second Address | Fullerton, CA 92835-2000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2011 |
Last Update Date | 11/02/2011 |