Provider Demographics
NPI:1679646350
Name:BECK, DAVID H (PAC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:H
Last Name:BECK
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3815 E BELL RD STE 2200
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2139
Mailing Address - Country:US
Mailing Address - Phone:602-633-3848
Mailing Address - Fax:602-633-3841
Practice Address - Street 1:6040 N 43RD AVE STE 1
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301-5481
Practice Address - Country:US
Practice Address - Phone:623-931-2221
Practice Address - Fax:623-934-2849
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ2288363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ623993Medicaid
AZ623993Medicaid
AZ82868Medicare PIN
AZ623993Medicaid