MEDICARE: DR. DONALD HOROWITZ 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
1	2084P0800X	Psychiatry Physician	A22814	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00A228140	OTHER	CA	BLUE SHIELD

General Provider Information

NPI Number	:	1982734356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD HOROWITZ MD

Provider Business Mailing Address
First Line	:	PO BOX 1990
Second Line	:
City	:	CLAREMONT
State	:	CA
Zip	:	91711-8990
Country	:	US
Telephone Number	:	909-625-5509
Fax Number	:	909-625-5508

Provider Business Practice Location Address
First Line	:	480 N INDIAN HILL BLVD
Second Line	:	STE. A-1
City	:	CLAREMONT
State	:	CA
Zip	:	91711-4615
Country	:	US
Telephone Number	:	909-625-5509
Fax Number	:	909-625-5508

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

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	03/26/2014

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