Basic Information
| Provider Information | |||||||||
| NPI: | 1356322879 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BECK | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 905 | ||||||||
| Address2: | |||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928566905 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7146344567 | ||||||||
| FaxNumber: | 7146344569 | ||||||||
| Practice Location | |||||||||
| Address1: | 280 S MAIN ST | ||||||||
| Address2: | STE 200 | ||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928683852 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7146344567 | ||||||||
| FaxNumber: | 7146344569 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/10/2005 | ||||||||
| LastUpdateDate: | 10/22/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | G56068 | CA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 00G560680 | 05 | CA | MEDICAID |