Provider Demographics
NPI:1619144151
Name:BECK, TIFFANY LEE (MD)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:LEE
Last Name:BECK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 HOSPITAL RD STE 507
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3500
Mailing Address - Country:US
Mailing Address - Phone:949-642-1361
Mailing Address - Fax:949-642-1608
Practice Address - Street 1:351 HOSPITAL RD STE 507
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3500
Practice Address - Country:US
Practice Address - Phone:949-642-1361
Practice Address - Fax:949-642-1608
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD443853207V00000X
WA60374607207VX0201X
390200000X
CA148151207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program