Healthcare Provider Details

I. General information

NPI: 1346216652
Provider Name (Legal Business Name): RAYMUND R DAVID M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 06/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 VALLEY CHILDRENS PL
MADERA CA
93636-8761
US

IV. Provider business mailing address

9300 VALLEY CHILDRENS PL
MADERA CA
93636-8761
US

V. Phone/Fax

Practice location:
  • Phone: 559-353-6215
  • Fax: 559-353-6222
Mailing address:
  • Phone: 559-353-6215
  • Fax: 559-353-6222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberA106007
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: