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Individual

DR. BRUCE B BECKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5363 BALBOA BLVD, SUITE 246, ENCINO, CA 91316-2805
(818) 783-3510
(818) 783-9059
Mailing address
5363 BALBOA BLVD, STE 246, ENCINO, CA 91316-2805
(818) 783-3510
(818) 783-9059

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
C40316
CA
207W00000X
Ophthalmology Physician
Primary
C40316
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00C403160
CA
Enumeration date
06/09/2006
Last updated
08/07/2014
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