Provider Demographics
NPI:1356359830
Name:BECKER, JOHN CLETUS (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CLETUS
Last Name:BECKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2500 HOSPITAL DR
Mailing Address - Street 2:#7
Mailing Address - City:MT VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040
Mailing Address - Country:US
Mailing Address - Phone:650-968-7118
Mailing Address - Fax:408-732-0374
Practice Address - Street 1:2500 HOSPITAL DR
Practice Address - Street 2:#7
Practice Address - City:MT VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040
Practice Address - Country:US
Practice Address - Phone:650-968-7118
Practice Address - Fax:408-732-0374
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG17632207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
A89279Medicare UPIN