Provider Demographics
NPI:1710090055
Name:DAVID B. STANTON M.D. & ASSOCIATES, A MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:DAVID B. STANTON M.D. & ASSOCIATES, A MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:B
Authorized Official - Last Name:STANTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-835-5100
Mailing Address - Street 1:1140 W LA VETA AVE
Mailing Address - Street 2:SUITE 555
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4223
Mailing Address - Country:US
Mailing Address - Phone:714-835-5100
Mailing Address - Fax:714-835-5567
Practice Address - Street 1:1140 W LA VETA AVE
Practice Address - Street 2:SUITE 555
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4223
Practice Address - Country:US
Practice Address - Phone:714-835-5100
Practice Address - Fax:714-835-5567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAFNP20614207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0058420Medicaid
CAW12247Medicare PIN