Healthcare Provider Details

I. General information

NPI: 1184890816
Provider Name (Legal Business Name): DAVID FUCHS MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2008
Last Update Date: 06/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7222 HASKELL AVE
VAN NUYS CA
91406-3256
US

IV. Provider business mailing address

7222 HASKELL AVE
VAN NUYS CA
91406-3256
US

V. Phone/Fax

Practice location:
  • Phone: 818-570-2863
  • Fax: 818-373-4811
Mailing address:
  • Phone: 818-570-2863
  • Fax: 818-373-4811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberG63731
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License NumberG63731
License Number StateCA

VIII. Authorized Official

Name: DR. DAVID ANDREW FUCHS
Title or Position: PRESIDENT
Credential: MD
Phone: 818-570-2863