Provider Demographics
NPI:1720079130
Name:BECK, CYNTHIA MAXINE (MD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:MAXINE
Last Name:BECK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CYNTHIA
Other - Middle Name:MAXINE
Other - Last Name:BECK-ALAVAZO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:14901 RINALDI ST
Mailing Address - Street 2:SUITE #200
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91345
Mailing Address - Country:US
Mailing Address - Phone:818-365-8553
Mailing Address - Fax:818-242-8761
Practice Address - Street 1:14901 RINALDI ST
Practice Address - Street 2:#200
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345
Practice Address - Country:US
Practice Address - Phone:818-365-8553
Practice Address - Fax:818-838-9279
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA65996208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
H76365Medicare UPIN
CAH76365Medicare UPIN