MEDICARE: DR. DAVID H. IRWIN 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	174400000X	Specialist	G68429	CA
2	207RH0003X	Hematology & Oncology Physician	G68429	CA

General Provider Information

NPI Number	:	1780672048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID H. IRWIN M.D.

Provider Business Mailing Address
First Line	:	2001 DWIGHT WAY
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94704-2608
Country	:	US
Telephone Number	:	510-204-6402
Fax Number	:	510-848-0801

Provider Business Practice Location Address
First Line	:	2001 DWIGHT WAY
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94704-2608
Country	:	US
Telephone Number	:	510-204-6402
Fax Number	:	510-848-0801

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

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	03/17/2010

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