Provider Demographics
NPI:1689771370
Name:BEENHOUWER, DAVID OWEN (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:OWEN
Last Name:BEENHOUWER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11301 WILSHIRE BLVD
Mailing Address - Street 2:DIVISION OF INFECTIOUS DISEASES (111F)
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90073-1003
Mailing Address - Country:US
Mailing Address - Phone:310-268-3015
Mailing Address - Fax:310-268-4928
Practice Address - Street 1:11301 WILSHIRE BLVD
Practice Address - Street 2:DIVISION OF INFECTIOUS DISEASES (111F)
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90073-1003
Practice Address - Country:US
Practice Address - Phone:310-268-3015
Practice Address - Fax:310-268-4928
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG86011207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease