Provider Demographics
NPI:1689706137
Name:FOX, DAVID P (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:P
Last Name:FOX
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8370 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2333
Mailing Address - Country:US
Mailing Address - Phone:323-653-2785
Mailing Address - Fax:323-653-2786
Practice Address - Street 1:8370 WILSHIRE BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2333
Practice Address - Country:US
Practice Address - Phone:323-653-2785
Practice Address - Fax:323-653-2786
Is Sole Proprietor?:No
Enumeration Date:2007-03-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY7702103T00000X, 103TC0700X, 103TF0200X
MD1506103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA621330OtherNAICS
CA16412OtherBLUE SHIELD
CA1232OtherCPQ
CACP7702Medicare ID - Type UnspecifiedCLINICAL PSYCHOLOGIST
CA16412OtherBLUE SHIELD