Provider Demographics
NPI:1801039177
Name:BULGER BECK, JOY ELIZABETH
Entity Type:Individual
Prefix:MRS
First Name:JOY
Middle Name:ELIZABETH
Last Name:BULGER BECK
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JOY
Other - Middle Name:ELIZABETH
Other - Last Name:BULGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:29364 CANYON RIM PL
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91387-5901
Mailing Address - Country:US
Mailing Address - Phone:661-291-3444
Mailing Address - Fax:
Practice Address - Street 1:24035 NEWHALL RANCH RD
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91355-5702
Practice Address - Country:US
Practice Address - Phone:661-291-3444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-15
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA114915207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program