MEDICARE: DR. DAVID WINSTON CHESHIRE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	G47665	CA
2	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	G47665	CA
3	2083X0100X	Occupational Medicine Physician	G47665	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	W8237	OTHER	CA	MEDICARE GROUP PROVIDER NUMBER

General Provider Information

NPI Number	:	1134261829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID WINSTON CHESHIRE M.D.

Provider Business Mailing Address
First Line	:	17232 RED HILL AVE
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92614-5628
Country	:	US
Telephone Number	:	949-752-1111
Fax Number	:

Provider Business Practice Location Address
First Line	:	18582 BEACH BLVD STE 23A
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92648-2012
Country	:	US
Telephone Number	:	714-964-4448
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	04/30/2008

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