Provider Demographics
NPI:1780816207
Name:W. DAVID WESTINGHOUSE, JR., MD INC.
Entity Type:Organization
Organization Name:W. DAVID WESTINGHOUSE, JR., MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:WESTINGHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-747-4115
Mailing Address - Street 1:750 E GRAND AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-4460
Mailing Address - Country:US
Mailing Address - Phone:760-747-4115
Mailing Address - Fax:760-233-8030
Practice Address - Street 1:750 E GRAND AVE
Practice Address - Street 2:SUITE E
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4460
Practice Address - Country:US
Practice Address - Phone:760-747-4115
Practice Address - Fax:760-233-8030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-17
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG24168207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA8922018OtherMEDI-CAL PIN
CA00G241680OtherMEDI-CAL RENDERING DOCTOR
CA8922018OtherMEDI-CAL PIN