MEDICARE: DR. DAVID HOWARD WHITAKER D.O.

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	207P00000X	Emergency Medicine Physician	DR.0075037	CO
2	207P00000X	Emergency Medicine Physician	20A8427	CA

General Provider Information

NPI Number	:	1255331203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID HOWARD WHITAKER D.O.

Provider Business Mailing Address
First Line	:	9961 SIERRA AVE
Second Line	:
City	:	FONTANA
State	:	CA
Zip	:	92335-6720
Country	:	US
Telephone Number	:	909-427-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	9961 SIERRA AVE
Second Line	:
City	:	FONTANA
State	:	CA
Zip	:	92335-6720
Country	:	US
Telephone Number	:	909-427-5000
Fax Number	:

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

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	05/29/2025

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