MEDICARE: DR. DAVID RICHARD MCGREW M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	G352680	CA

General Provider Information

NPI Number	:	1053337956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID RICHARD MCGREW M.D.

Provider Business Mailing Address
First Line	:	6377 RIVERSIDE AVE
Second Line	:	STE 170
City	:	RIVERSIDE
State	:	CA
Zip	:	92506-3155
Country	:	US
Telephone Number	:	951-248-4381
Fax Number	:	951-248-4389

Provider Business Practice Location Address
First Line	:	6377 RIVERSIDE AVE
Second Line	:	SUITE 170
City	:	RIVERSIDE
State	:	CA
Zip	:	92506-3124
Country	:	US
Telephone Number	:	951-248-4381
Fax Number	:	951-248-4389

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	04/28/2020

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