1780816207 NPI number — W. DAVID WESTINGHOUSE, JR., MD INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780816207 NPI number — W. DAVID WESTINGHOUSE, JR., MD INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
W. DAVID WESTINGHOUSE, JR., MD INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780816207
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/17/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
750 E GRAND AVE
Provider Second Line Business Mailing Address:
SUITE E
Provider Business Mailing Address City Name:
ESCONDIDO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92025-4460
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-747-4115
Provider Business Mailing Address Fax Number:
760-233-8030

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
750 E GRAND AVE
Provider Second Line Business Practice Location Address:
SUITE E
Provider Business Practice Location Address City Name:
ESCONDIDO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92025-4460
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-747-4115
Provider Business Practice Location Address Fax Number:
760-233-8030
Provider Enumeration Date:
08/17/2009

Additional Information

Authorized Official

Authorized Official Last Name:
WESTINGHOUSE
Authorized Official First Name:
WALTER
Authorized Official Middle Name:
DAVID
Authorized Official Title or Position:
OWNER/PROVIDER
Authorized Official Telephone Number:
760-747-4115

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  G24168 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 8922018 . This is a "MEDI-CAL PIN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 00G241680 . This is a "MEDI-CAL RENDERING DOCTOR" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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