Healthcare Provider Details

I. General information

NPI: 1477638492
Provider Name (Legal Business Name): DAVID R PLOSS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 04/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2332 23RD ST
EUREKA CA
95501-3231
US

IV. Provider business mailing address

PO BOX 6980
EUREKA CA
95502-6980
US

V. Phone/Fax

Practice location:
  • Phone: 707-444-8300
  • Fax: 707-444-8349
Mailing address:
  • Phone: 707-444-8300
  • Fax: 707-444-8349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberG066128
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberG066128
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License NumberG066128
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: