Provider Demographics
NPI:1033487913
Name:IRWIN, DAVID BRUCE (PHARM D)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:BRUCE
Last Name:IRWIN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 S SUNRISE WAY
Mailing Address - Street 2:SUITE 112-113
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92264-7869
Mailing Address - Country:US
Mailing Address - Phone:760-323-1973
Mailing Address - Fax:
Practice Address - Street 1:555 S SUNRISE WAY
Practice Address - Street 2:SUITE 112-113
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92264-7869
Practice Address - Country:US
Practice Address - Phone:760-323-1973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-07
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36455183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist