Active NPI
Clyde Houghton Beck, Jr. Jr., MD
- Nephrology Physician
- La Jolla, CA
National Provider Identifier
1457797169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- CFE36099
- Practice address
- 6412 Cardeno Dr
La Jolla, CA 92037 - Phone
- (858) 231-1124
- NPI assigned
- May 21, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | CFE36099 | CA | Primary |
Addresses
Primary practice location
6412 Cardeno Dr
La Jolla, CA 92037
Mailing address
6412 Cardeno Dr.
La Jolla, CA 92037
Phone (858) 231-1124
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CFE36099 | CA | MD | Nephrology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369094400000",
"number": "1457797169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6412 CARDENO DR.",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "92037",
"telephone_number": "858-231-1124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6412 CARDENO DR",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "92037",
"telephone_number": "858-231-1124"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BECK, JR.",
"first_name": "CLYDE",
"middle_name": "HOUGHTON",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-05-21",
"last_updated": "2013-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "CA",
"license": "CFE36099",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Jolla, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.