Provider Demographics
NPI:1437136660
Name:PRATT, DONALD J (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:J
Last Name:PRATT
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Gender:M
Credentials:MD
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Mailing Address - Street 1:26522 LA ALAMEDA
Mailing Address - Street 2:SUITE 120
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6330
Mailing Address - Country:US
Mailing Address - Phone:949-282-1671
Mailing Address - Fax:949-367-0518
Practice Address - Street 1:26800 CROWN VALLEY PKWY
Practice Address - Street 2:SUITE 325
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6384
Practice Address - Country:US
Practice Address - Phone:949-364-6000
Practice Address - Fax:949-364-9561
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2021-11-09
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Provider Licenses
StateLicense IDTaxonomies
CAG48502207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G485020Medicaid
CAWG48502AMedicare PIN
CA00G485020Medicaid
CAGV946ZMedicare PIN