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General NPI Number Information
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NPI Number | 1386833945
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Entity Type | Organization
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Legal Business Name | DAVID SIZEMORE JR MD A PROFESSIONAL
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Dates
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Enumeration Date | 10/19/2007
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Last Update Date | 08/05/2015
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Provider Practice Location Address
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Address Line | 1030 SAINT JOHN PL
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City | HEMET
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State | CA
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Zip | 92543-4422
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Country | US
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Telephone | 951-929-2300
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Fax | 951-929-0584
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Provider Business Mailing Address
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Address Line | 1030 SAINT JOHN PL
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City | HEMET
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State | CA
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Zip | 92543-4422
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Country | US
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Telephone | 951-929-2300
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Fax | 951-929-0584
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID ALDEN SIZEMORE
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Credential | M.D.
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Telephone | 951-929-2300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | G041592
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | G041592
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License Number State | CA
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