Healthcare Provider Details

I. General information

NPI: 1245284546
Provider Name (Legal Business Name): DAVID H TOTTORI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 04/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 E CHARLESTON BLVD STE 100
LAS VEGAS NV
89104-6683
US

IV. Provider business mailing address

4000 E CHARLESTON BLVD STE 100
LAS VEGAS NV
89104-6683
US

V. Phone/Fax

Practice location:
  • Phone: 702-432-8250
  • Fax: 702-734-6677
Mailing address:
  • Phone: 702-432-8250
  • Fax: 702-734-6677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number6370
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: