MEDICARE: DAVID DEYHIMY 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	207LA0401X	Addiction Medicine (Anesthesiology) Physician	A82776	CA
2	207L00000X	Anesthesiology Physician	A827760	CA

General Provider Information

NPI Number	:	1376528489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID DEYHIMY M.D.

Provider Business Mailing Address
First Line	:	PO BOX 10429
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92658-0429
Country	:	US
Telephone Number	:	949-417-1812
Fax Number	:	949-417-1803

Provider Business Practice Location Address
First Line	:	24451 HEALTH CENTER DR
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-3689
Country	:	US
Telephone Number	:	949-837-4500
Fax Number	:	949-837-4621

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

Provider Enumeration Date	:	12/12/2005
Last Update Date	:	10/18/2023

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