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General NPI Number Information
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NPI Number | 1831358027
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Entity Type | Organization
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Legal Business Name | DAVID F LA ROCHELLE MD A MEDICAL CORPORATION
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Dates
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Enumeration Date | 06/03/2008
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Last Update Date | 06/03/2008
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Provider Practice Location Address
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Address Line | 1261 TRAVIS BLVD SUITE 190
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City | FAIRFIELD
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State | CA
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Zip | 94533-4897
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Country | US
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Telephone | 707-427-5020
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Fax | 707-427-5023
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Provider Business Mailing Address
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Address Line | 1261 TRAVIS BLVD SUITE 190
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City | FAIRFIELD
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State | CA
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Zip | 94533-4897
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Country | US
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Telephone | 707-427-5020
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Fax | 707-427-5023
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Authorized Official
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Title or Position | CEO
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Name | DR. DAVID F LA ROCHELLE
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Credential | MD
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Telephone | 707-427-5020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | C 38056
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License Number State | CA
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