Provider Demographics
NPI:1952345142
Name:BECK, ROBERT GARY (DO)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:GARY
Last Name:BECK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 W STETSON AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-7311
Mailing Address - Country:US
Mailing Address - Phone:951-537-6002
Mailing Address - Fax:
Practice Address - Street 1:890 W STETSON AVE
Practice Address - Street 2:APEX RADIOLOGY MEDICAL GROUP, INC.
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-7311
Practice Address - Country:US
Practice Address - Phone:951-537-6002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A76142085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA020A76145OtherMEDICARE PTAN
CA020A76143OtherMEDICARE PTAN
CA020A76144OtherMEDICARE PTAN
CA020A76141OtherMEDICARE PTAN
CA00AX76140Medicaid
CA020A76145OtherMEDICARE PTAN
CAH98888Medicare UPIN
CA020A76142Medicare ID - Type Unspecified