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NPI Code Detail

MEDICARE: DAVID TALBOTT WARREN DAVID WARREN

MEDICARE:   DAVID TALBOTT WARREN  DAVID WARREN
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
11223G0001XGeneral Practice Dentistry25051CA

General Provider Information

NPI Number : 1598789349
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID TALBOTT WARREN DAVID WARREN
Provider Business Mailing Address
First Line : 1500 TARA HILLS DR STE 104
Second Line :
City : PINOLE
State : CA
Zip : 94564-2526
Country : US
Telephone Number : 510-724-8541
Fax Number : 510-724-0420
Provider Business Practice Location Address
First Line : 1500 TARA HILLS DR STE 104
Second Line :
City : PINOLE
State : CA
Zip : 94564-2526
Country : US
Telephone Number : 510-724-8541
Fax Number : 510-724-0420
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2006
Last Update Date : 07/08/2007

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Directions to “ DAVID TALBOTT WARREN DAVID WARREN” Practice Location

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