Provider Demographics
NPI:1598807877
Name:FOOS, DAVID CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CHARLES
Last Name:FOOS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2810 EAST DEL MAR BOULEVARD
Mailing Address - Street 2:SUITE 11B
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107
Mailing Address - Country:US
Mailing Address - Phone:626-449-2874
Mailing Address - Fax:626-449-4907
Practice Address - Street 1:2810 EAST DEL MAR BOULEVARD
Practice Address - Street 2:SUITE 11B
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107
Practice Address - Country:US
Practice Address - Phone:626-449-2874
Practice Address - Fax:626-449-4907
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG321872084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW11133Medicare ID - Type Unspecified
A45053Medicare UPIN