Individual
DOUGLAS LOUIS PRISCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD.
Contact information
Practice address
11333 SEPULVEDA BLVD, MISSION HILLS, CA 91345-1116
(818) 365-9531
Mailing address
PO BOX 9602, MISSION HILLS, CA 91346-9602
(818) 837-5691
(818) 792-4793
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A108810
CA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
236893
NY
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
A108810
CA
207RP1001X
Pulmonary Disease Physician
236893
NY
207RP1001X
Pulmonary Disease Physician
Primary
A108810
CA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
A108810
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A1088100
—
CA
01
—
1902846306
GROUP NPI
CA
01
—
GR0100430
GROUP MEDICAL
CA
01
—
W18762
GROUP MEDICARE
CA
Enumeration date
05/15/2007
Last updated
05/15/2026
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