Healthcare Provider Details

I. General information

NPI: 1871526590
Provider Name (Legal Business Name): DAVID F LEMMEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 06/06/2023
Certification Date: 06/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 N THIRD ST
LOMPOC CA
93436-7002
US

IV. Provider business mailing address

136 N THIRD ST
LOMPOC CA
93436-7002
US

V. Phone/Fax

Practice location:
  • Phone: 805-736-1253
  • Fax: 843-497-9940
Mailing address:
  • Phone: 805-736-1253
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA108587
License Number StateCA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier288922
Identifier TypeMEDICAID
Identifier StateSC
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: