Individual
DWIGHT A DAVID
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15111 WHITTIER BLVD, STE 102, WHITTIER, CA 90603-2136
(562) 945-6440
(562) 945-9121
Mailing address
15111 WHITTIER BLVD, STE 102, WHITTIER, CA 90603-2136
(562) 945-6440
(562) 945-9121
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A40764
CA
Other
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
Enumeration date
07/20/2005
Last updated
12/07/2007
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