Provider Demographics
NPI:1689963340
Name:DAVID, CONSUELO VERONICA (MD)
Entity Type:Individual
Prefix:MISS
First Name:CONSUELO
Middle Name:VERONICA
Last Name:DAVID
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3640 LOMITA BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-3956
Mailing Address - Country:US
Mailing Address - Phone:310-405-0693
Mailing Address - Fax:310-356-9126
Practice Address - Street 1:3640 LOMITA BLVD STE 301
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-3956
Practice Address - Country:US
Practice Address - Phone:310-405-0693
Practice Address - Fax:310-356-9126
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA122615207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology