Healthcare Provider Details

I. General information

NPI: 1568658292
Provider Name (Legal Business Name): DAVID LOUIS LUNSFORD CRNA, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2007
Last Update Date: 09/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W CARSON ST # 10
TORRANCE CA
90509
US

IV. Provider business mailing address

1000 W CARSON ST #10
TORRANCE CA
90509
US

V. Phone/Fax

Practice location:
  • Phone: 310-222-3477
  • Fax: 310-782-1467
Mailing address:
  • Phone: 310-222-3477
  • Fax: 310-782-1467

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number638640
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number3461
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: