Provider Demographics
NPI:1497892137
Name:BRIAN A BECK MD A MEDICAL CORP ETAL PTR LEONARD A GALE MD MEDICAL CORP
Entity Type:Organization
Organization Name:BRIAN A BECK MD A MEDICAL CORP ETAL PTR LEONARD A GALE MD MEDICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-698-6296
Mailing Address - Street 1:12291 WASHINGTON BLVD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90606-2500
Mailing Address - Country:US
Mailing Address - Phone:562-698-6296
Mailing Address - Fax:562-693-6752
Practice Address - Street 1:101 E BEVERLY BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-4300
Practice Address - Country:US
Practice Address - Phone:323-725-7297
Practice Address - Fax:323-725-0335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG40274OtherSTATE LICENSE
CAA23344OtherSTATE LICENSE
CAA25381OtherSTATE LICENSE
CAA61369OtherSTATE LICENSE
CAA69058OtherSTATE LICENSE
CAG40274OtherSTATE LICENSE