Provider Demographics
NPI:1316382849
Name:HERMIZ, DAVID JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOSEPH
Last Name:HERMIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3415 S SEPULVEDA BLVD STE 1100
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-7090
Mailing Address - Country:US
Mailing Address - Phone:424-348-4558
Mailing Address - Fax:
Practice Address - Street 1:3415 S SEPULVEDA BLVD STE 1100
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-7090
Practice Address - Country:US
Practice Address - Phone:424-348-4558
Practice Address - Fax:424-377-6076
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-10
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA133957174400000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No174400000XOther Service ProvidersSpecialist