MEDICARE: DAVID ANTONIO IRIAS RN

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	95143251	CA
2	163WA0400X	Addiction (Substance Use Disorder) Registered Nurse	RN95143251	CA
3	163WM0705X	Medical-Surgical Registered Nurse	RN95143251	CA
4	163WP0808X	Psychiatric/Mental Health Registered Nurse	RN95143251	CA

General Provider Information

NPI Number	:	1164831368
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID ANTONIO IRIAS RN

Provider Business Mailing Address
First Line	:	1366 W 38TH ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90062-1236
Country	:	US
Telephone Number	:	323-286-8723
Fax Number	:

Provider Business Practice Location Address
First Line	:	1366 W 38TH ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90062-1236
Country	:	US
Telephone Number	:	323-286-8723
Fax Number	:

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

Provider Enumeration Date	:	08/13/2014
Last Update Date	:	11/19/2025

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