Provider Demographics
NPI:1982754305
Name:BRIAN A BECK MD A MEDICAL CORP ETAL PTR LEONARD A GALE MD MEDICAL CORP
Entity Type:Organization
Organization Name:BRIAN A BECK MD A MEDICAL CORP ETAL PTR LEONARD A GALE MD MEDICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:QUON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-698-6296
Mailing Address - Street 1:12291 WASHINGTON BLVD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90606-2500
Mailing Address - Country:US
Mailing Address - Phone:562-698-6296
Mailing Address - Fax:562-693-6752
Practice Address - Street 1:12291 WASHINGTON BLVD
Practice Address - Street 2:SUITE 303
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90606-2500
Practice Address - Country:US
Practice Address - Phone:562-698-6296
Practice Address - Fax:562-693-6752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW7607Medicare PIN
CAA23493Medicare UPIN
CAH22563Medicare UPIN
CAA24412Medicare UPIN
CAA48168Medicare UPIN
CAH52836Medicare UPIN