Healthcare Provider Details

I. General information

NPI: 1366549255
Provider Name (Legal Business Name): DAVID D OH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21350 HAWTHORNE BLVD STE 260
TORRANCE CA
90503-5645
US

IV. Provider business mailing address

21350 HAWTHORNE BLVD STE 260
TORRANCE CA
90503-5645
US

V. Phone/Fax

Practice location:
  • Phone: 310-543-2977
  • Fax: 310-543-3147
Mailing address:
  • Phone: 310-543-2977
  • Fax: 310-543-3147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberA044047
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: