# DWIGHT A DAVID

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1487653531
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | A40764 | CA | Yes |

## Other

- **Enumeration date:** 07/20/2005
- **Last updated:** 12/07/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00A407640 | BLUE SHIELD | CA |
| 05 | — | 00A407640 | — | CA |
| 01 | — | 110232328 | MEDICARE RAIL ROAD | CA |
| 01 | — | A40764 | BCBS | CA |
| 01 | — | B010 | CHAMPUS | CA |