Provider Demographics
NPI:1871653634
Name:BECK, DAVID CHARLES (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:CHARLES
Last Name:BECK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9707 ROSS STATION RD
Mailing Address - Street 2:
Mailing Address - City:SEBASTOPOL
Mailing Address - State:CA
Mailing Address - Zip Code:95472-2136
Mailing Address - Country:US
Mailing Address - Phone:707-887-2315
Mailing Address - Fax:707-887-2315
Practice Address - Street 1:9707 ROSS STATION RD
Practice Address - Street 2:
Practice Address - City:SEBASTOPOL
Practice Address - State:CA
Practice Address - Zip Code:95472-2136
Practice Address - Country:US
Practice Address - Phone:707-887-2315
Practice Address - Fax:707-887-2315
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG0409502084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry