Provider Demographics
NPI:1790339364
Name:DAVID J. FUERST, M.D., INC
Entity Type:Organization
Organization Name:DAVID J. FUERST, M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:SHAMPAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-856-2020
Mailing Address - Street 1:1135 SOUTH SUNSET AVE.
Mailing Address - Street 2:SUITE 312
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-3965
Mailing Address - Country:US
Mailing Address - Phone:626-856-2020
Mailing Address - Fax:626-962-0974
Practice Address - Street 1:1808 VERDUGO BLVD SUITE 103
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91208-1482
Practice Address - Country:US
Practice Address - Phone:818-957-2020
Practice Address - Fax:626-962-0974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-31
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0120XAllopathic & Osteopathic PhysiciansOphthalmologyCornea and External Diseases SpecialistGroup - Single Specialty