Provider Demographics
NPI:1386986966
Name:BECKER, ALBERT (CPO)
Entity type:Individual
Prefix:
First Name:ALBERT
Middle Name:
Last Name:BECKER
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 45342
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94145-0342
Mailing Address - Country:US
Mailing Address - Phone:800-726-9180
Mailing Address - Fax:800-861-5950
Practice Address - Street 1:2120 FOREST AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1478
Practice Address - Country:US
Practice Address - Phone:408-217-9387
Practice Address - Fax:408-866-4045
Is Sole Proprietor?:No
Enumeration Date:2013-03-21
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist