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Individual

MR. PHILLIP H BECK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1541 FLORIDA AVE, SUITE 200, MODESTO, CA 95350-4429
(209) 577-3388
(209) 523-0764
Mailing address
1541 FLORIDA AVE, SUITE 200, MODESTO, CA 95350-4429
(209) 577-3388
(209) 523-0764

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
G21753
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CD069A
GROUP PTAN- MEDICARE (MODESTO, TURLOCK LOCATIONS)
CA
01
CD069B
GROUP PTAN - MEDICARE (MANTECA LOCATION)
CA
01
CD116Y
INDIVIDUAL PTAN - MEDICARE (MANTECA LOCATION)
CA
01
CD116Z
INDIVIDUAL PTAN- MEDICARE (MODESTO, TURLOCK LOCATIONS)
CA
01
ZZZ48224Z
MEDICARE #
CA
Enumeration date
07/14/2006
Last updated
03/29/2011
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