MEDICARE: DR. DAVID JAMES ENGSTROM 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	207Q00000X	Family Medicine Physician	4310	AZ

General Provider Information

NPI Number	:	1710058870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID JAMES ENGSTROM D.O.

Provider Business Mailing Address
First Line	:	14044 W CAMELBACK RD STE 204
Second Line	:
City	:	LITCHFIELD PARK
State	:	AZ
Zip	:	85340-9426
Country	:	US
Telephone Number	:	623-935-9600
Fax Number	:	623-935-9602

Provider Business Practice Location Address
First Line	:	14044 W CAMELBACK RD
Second Line	:	SUITE 126
City	:	LITCHFIELD PARK
State	:	AZ
Zip	:	85340-9428
Country	:	US
Telephone Number	:	623-935-9600
Fax Number	:

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

Provider Enumeration Date	:	11/12/2006
Last Update Date	:	03/17/2018

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