Provider Demographics
NPI:1255324257
Name:MIDDLETON, DAVID K (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:K
Last Name:MIDDLETON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:16600 WOODRUFF AVE
Mailing Address - Street 2:STE 102
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-4916
Mailing Address - Country:US
Mailing Address - Phone:562-920-1600
Mailing Address - Fax:562-920-0895
Practice Address - Street 1:16600 WOODRUFF AVE
Practice Address - Street 2:STE 102
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-4916
Practice Address - Country:US
Practice Address - Phone:562-920-1600
Practice Address - Fax:562-920-0895
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY10157103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP10157Medicare ID - Type UnspecifiedPSYCHOLOGIST