Provider Demographics
NPI:1821101163
Name:STANTON, DAVID B (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:B
Last Name:STANTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1140 W LA VETA AVE
Mailing Address - Street 2:STE 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:STE 555
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868
Practice Address - Country:US
Practice Address - Phone:714-835-5100
Practice Address - Fax:714-835-5567
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG49428207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G494280Medicaid
CAWG49428AMedicare PIN
CA00G494280Medicaid