Doctor Name: | DWIGHT A DAVID |
NPI Number: | 1487653531 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | A40764 |
Business Practice Address: | 15111 Whittier Blvd Ste 102 Whittier, CA - 906032136 |
Business Phone Number: | 5629456440 |
Business Fax Number: | 5629459121 |
Mailing Address: | 15111 Whittier Blvd, Ste 102 WHITTIER |
State: | CA |
Postal Code: | 906032136 |
Phone Number: | 5629456440 |
Fax Number: | 5629459121 |
NPI Enumeration Date: | 07/20/2005 |
NPI Last Update Date: | 12/07/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A40764 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |