Provider Demographics
NPI:1316099732
Name:BECK, BRUCE W (MD)
Entity type:Individual
Prefix:
First Name:BRUCE
Middle Name:W
Last Name:BECK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2500 HOSPITAL DRIVE BLDG 15
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040
Mailing Address - Country:US
Mailing Address - Phone:650-969-0445
Mailing Address - Fax:650-969-4165
Practice Address - Street 1:2500 HOSPITAL DRIVE BLDG 15
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040
Practice Address - Country:US
Practice Address - Phone:650-969-0445
Practice Address - Fax:650-969-4165
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA00G324950207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA45167Medicare UPIN