Provider Demographics
NPI:1639118912
Name:BECKES, JOHN D (DO, PHD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:D
Last Name:BECKES
Suffix:
Gender:M
Credentials:DO, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2710 ALPINE BLVD
Mailing Address - Street 2:SUITE O- 244
Mailing Address - City:ALPINE
Mailing Address - State:CA
Mailing Address - Zip Code:91901-2276
Mailing Address - Country:US
Mailing Address - Phone:619-985-0532
Mailing Address - Fax:619-752-3979
Practice Address - Street 1:2400 E 4TH ST
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-2026
Practice Address - Country:US
Practice Address - Phone:619-472-4390
Practice Address - Fax:619-472-4699
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A6973208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1639118912Medicare PIN