Provider Demographics
NPI:1184646069
Name:WHITBREAD, DAVID HUGHES (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:HUGHES
Last Name:WHITBREAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5790 MAGNOLIA AVE
Mailing Address - Street 2:202
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-1874
Mailing Address - Country:US
Mailing Address - Phone:951-328-9454
Mailing Address - Fax:951-682-0519
Practice Address - Street 1:5790 MAGNOLIA AVE
Practice Address - Street 2:202
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-1874
Practice Address - Country:US
Practice Address - Phone:951-328-9454
Practice Address - Fax:951-682-0519
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC314882084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7353517Medicaid
CA7353517Medicaid