Individual
DR. DERRICK R DARNSTEADT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11301 WILSHIRE BLVD, EMERGENCY DEPARTMENT, LOS ANGELES, CA 90073-1003
(310) 268-3711
Mailing address
1825 WESTHOLME AVE APT 5, EMERGENCY DEPARTMENT, LOS ANGELES, CA 90025-4954
(310) 801-8546
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A92752
CA
207P00000X
Emergency Medicine Physician
MD.30306
AL
208D00000X
General Practice Physician
A92752
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122003
—
AL
05
—
128507
—
AL
01
—
1497725758
TRICARE SOUTH
AL
01
—
511-09380
BCBS
AL
01
—
Z10777
VIVA HEALTH
AL
Enumeration date
01/26/2006
Last updated
04/26/2017
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