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NPI Code Detail

MEDICARE: DAVID R NELSON MD

MEDICARE: DAVID R NELSON MD
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
1207RC0200XCritical Care Medicine (Internal Medicine) PhysicianG60128CA
2207RP1001XPulmonary Disease PhysicianG60128CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700886975
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID R NELSON MD
Provider Business Mailing Address
First Line : 2000 STADIUM WAY
Second Line :
City : LOS ANGELES
State : CA
Zip : 90026-2606
Country : US
Telephone Number : 323-428-6180
Fax Number : 213-202-6803
Provider Business Practice Location Address
First Line : 2000 STADIUM WAY
Second Line :
City : LOS ANGELES
State : CA
Zip : 90026-2606
Country : US
Telephone Number : 213-250-4200
Fax Number : 213-250-3274
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2005
Last Update Date : 03/08/2017

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