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General NPI Number Information
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NPI Number | 1497725758
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Entity Type | Individual
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Provider Name | DERRICK R DARNSTEADT MD
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Gender | Male
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Dates
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Enumeration Date | 01/26/2006
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Last Update Date | 04/26/2017
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Provider Practice Location Address
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Address Line | 11301 WILSHIRE BLVD EMERGENCY DEPARTMENT
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City | LOS ANGELES
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State | CA
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Zip | 90073-1003
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Country | US
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Telephone | 310-268-3711
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Fax |
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Provider Business Mailing Address
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Address Line | 1825 WESTHOLME AVE APT 5 EMERGENCY DEPARTMENT
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City | LOS ANGELES
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State | CA
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Zip | 90025-4954
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Country | US
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Telephone | 310-801-8546
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | A92752
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD.30306
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A92752
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License Number State | CA
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