Most Relevant Information
Provider Data
| NPI Number: | 1003547639 |
| Provider Name: | JACOB BECKER |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/23/2022 |
| Last Updated: | 08/19/2022 |
Provider Practice Location
301 THE CITY DR S # 44
ORANGE
CA
928683205
Practice Location Phone/Fax
| Phone: | 7148362736 |
| Fax: |
Provider Mailing Location
301 THE CITY DR S # 44
ORANGE
CA
928683205
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |