Provider Demographics
NPI:1992819247
Name:BECHARD, JONATHAN G (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:G
Last Name:BECHARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1555 S PALM CANYON DR BLDG C
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92264-8354
Mailing Address - Country:US
Mailing Address - Phone:760-969-7770
Mailing Address - Fax:760-969-7771
Practice Address - Street 1:1555 S PALM CANYON DR BLDG C
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92264-8354
Practice Address - Country:US
Practice Address - Phone:760-969-7770
Practice Address - Fax:760-969-7771
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC147138207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VADOOOMedicare UPIN