Provider Demographics
NPI:1346216652
Name:DAVID, RAYMUND R (MD)
Entity Type:Individual
Prefix:
First Name:RAYMUND
Middle Name:R
Last Name:DAVID
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9300 VALLEY CHILDRENS PL
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93636-8761
Mailing Address - Country:US
Mailing Address - Phone:559-353-6215
Mailing Address - Fax:559-353-6222
Practice Address - Street 1:9300 VALLEY CHILDRENS PL
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93636-8761
Practice Address - Country:US
Practice Address - Phone:559-353-6215
Practice Address - Fax:559-353-6222
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2013-06-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA1060072084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN388621200Medicaid
MN000080878OtherPRIMEWEST
MN315G2RAOtherBLUE CROSS
SD5549OtherDAKOTACARE
ND13414Medicaid
NE46022474339Medicaid
SD0500684OtherMEDICA
SD0500684OtherPREFERRED ONE
SD6100960Medicaid
SD44850OtherSANFORD HEALTH PLAN
SD2361647OtherARAZ/ AMERICA'S PPO
SD246832OtherMIDLANDS CHOICE
MN315G2RAOtherCC SYSTEMS/ BLUE PLUS
SD370624200OtherDEPT OF LABOR
SDHP53361OtherHEALTHPARTNERS
IA0592949Medicaid
SD4994690OtherBLUE CROSS
SD57105I011OtherWPS TRICARE
SDS100327Medicare PIN
SD5549OtherDAKOTACARE