Provider Demographics
NPI:1518996446
Name:LAVER, DAVID A (DPM)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:LAVER
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:2287 MOWRY AVE
Mailing Address - Street 2:A
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1622
Mailing Address - Country:US
Mailing Address - Phone:510-796-3267
Mailing Address - Fax:510-796-3268
Practice Address - Street 1:2287 MOWRY AVE
Practice Address - Street 2:A
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1622
Practice Address - Country:US
Practice Address - Phone:510-796-3267
Practice Address - Fax:510-796-3268
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2016-11-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAE2479213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADK605ZMedicare PIN
CAE24790Medicare UPIN