Healthcare Provider Details

I. General information

NPI: 1992012751
Provider Name (Legal Business Name): DAVID MELTZER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2010
Last Update Date: 08/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

727 N CAMDEN DR
BEVERLY HILLS CA
90210-3204
US

IV. Provider business mailing address

727 N CAMDEN DR
BEVERLY HILLS CA
90210-3204
US

V. Phone/Fax

Practice location:
  • Phone: 310-271-2041
  • Fax: 310-271-2269
Mailing address:
  • Phone: 310-271-2041
  • Fax: 310-271-2269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA18185
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: