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General NPI Number Information
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NPI Number | 1205035086
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Entity Type | Individual
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Provider Name | DAVID MALCOLM ODOM M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/12/2007
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Last Update Date | 06/15/2016
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Provider Practice Location Address
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Address Line | 3001 E TAHQUITZ CANYON WAY SUITE 108
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City | PALM SPRINGS
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State | CA
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Zip | 92262-6982
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Country | US
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Telephone | 858-900-1288
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Fax | 866-598-2420
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Provider Business Mailing Address
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Address Line | 3001 E TAHQUITZ CANYON WAY SUITE 108
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City | PALM SPRINGS
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State | CA
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Zip | 92262-6982
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Country | US
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Telephone | 858-900-1288
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Fax | 866-598-2420
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 1288
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License Number State | AK
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | C33440
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 1288
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License Number State | AK
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Taxonomy #4
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | C33440
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | C33440
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 2083B0002X
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Taxonomy Name | Obesity Medicine (Preventive Medicine) Physician
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License Number | C33440
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License Number State | CA
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