Provider Demographics
NPI:1669674644
Name:PRIVETT, DARRIN DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:DARRIN
Middle Name:DAVID
Last Name:PRIVETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2524 30TH DR
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-2748
Mailing Address - Country:US
Mailing Address - Phone:718-267-8704
Mailing Address - Fax:
Practice Address - Street 1:23542 LYONS AVE
Practice Address - Street 2:#210
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-2560
Practice Address - Country:US
Practice Address - Phone:661-253-9452
Practice Address - Fax:661-253-9455
Is Sole Proprietor?:No
Enumeration Date:2007-06-03
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU5493207P00000X
CAA100314207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine