Provider Demographics
NPI:1770512287
Name:MONARREZ, DAVID (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:MONARREZ
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 1:31739 RIVERSIDE DR STE A1
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92530-7818
Mailing Address - Country:US
Mailing Address - Phone:951-245-0505
Mailing Address - Fax:951-245-0999
Practice Address - Street 1:1307 W 6TH ST
Practice Address - Street 2:SUITE 113
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-3294
Practice Address - Country:US
Practice Address - Phone:951-278-8910
Practice Address - Fax:951-278-9895
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA048724208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A487240Medicaid
CA00A487240Medicaid
F14100Medicare UPIN