Active NPI
Dwight A David, MD
- General Practice Physician
- Whittier, CA
National Provider Identifier
1487653531
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- A40764
- Practice address
- 15111 Whittier Blvd
Ste 102
Whittier, CA 90603-2136 - Phone
- (562) 945-6440
- Fax
- (562) 945-9121
- NPI assigned
- Jul 20, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | A40764 | CA | Primary |
Addresses
Primary practice location
15111 Whittier Blvd
Ste 102
Whittier, CA 90603-2136
Mailing address
15111 Whittier Blvd
Ste 102
Whittier, CA 90603-2136
Phone (562) 945-6440
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A407640 | Other | CA | BLUE SHIELD |
| A40764 | Other | CA | BCBS |
| B010 | Other | CA | CHAMPUS |
| 00A407640 | Medicaid | CA | |
| 110232328 | Other | CA | MEDICARE RAIL ROAD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120314000440 | CA | Practitioner - Internal Medicine | 4880853654 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196985600000",
"number": "1487653531",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15111 WHITTIER BLVD",
"address_2": "STE 102",
"city": "WHITTIER",
"state": "CA",
"postal_code": "906032136",
"telephone_number": "562-945-6440",
"fax_number": "562-945-9121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15111 WHITTIER BLVD",
"address_2": "STE 102",
"city": "WHITTIER",
"state": "CA",
"postal_code": "906032136",
"telephone_number": "562-945-6440",
"fax_number": "562-945-9121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVID",
"first_name": "DWIGHT",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-20",
"last_updated": "2007-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "CA",
"license": "A40764",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "00A407640",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "A40764",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "B010",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A407640",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAIL ROAD",
"identifier": "110232328",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Whittier, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.