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Organization

BECK CHIROPRACTIC PROFESSIONAL CORPORATION

Active
Other names
Beck Chiropractic PC
Organization subpart
No

Provider details

NPI number
Authorized official
JASON P BECK D.C. (PRESIDENT)
(707) 766-6363
Entity
Organization

Contact information

Practice address
6 PETALUMA BLVD N STE B8, PETALUMA, CA 94952-3051
(707) 766-6363
(707) 766-6218
Mailing address
6 PETALUMA BLVD N STE B8, PETALUMA, CA 94952-3051
(707) 766-6363
(707) 766-6218

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC 28208
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1700813540
INDIVIDUAL NPI #
CA
01
DC028080
MEDICARE
CA
01
ZZZ021402
GROUP PTAM #
CA
Enumeration date
01/05/2009
Last updated
09/04/2009
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