Healthcare Provider Details
I. General information
NPI: 1750425278
Provider Name (Legal Business Name): DAVID PLURAD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/17/2007
Last Update Date: 09/22/2023
Certification Date: 09/22/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4234 RIVERWALK PKWY STE 120
RIVERSIDE CA
92505-3304
US
IV. Provider business mailing address
520 W LAUREL AVE
SIERRA MADRE CA
91024-1614
US
V. Phone/Fax
- Phone: 951-781-3672
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | G87433 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0127X |
| Taxonomy | Trauma Surgery Physician |
| License Number | G87433 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0102X |
| Taxonomy | Surgical Critical Care Physician |
| License Number | G87433 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: