Provider Demographics
NPI:1891086104
Name:APPLEBAUM, DAVID IRA (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:IRA
Last Name:APPLEBAUM
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 1:1781 STONE CANYON ROAD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-1914
Mailing Address - Country:US
Mailing Address - Phone:310-472-4728
Mailing Address - Fax:
Practice Address - Street 1:1781 STONE CANYON ROAD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90077-1914
Practice Address - Country:US
Practice Address - Phone:310-472-4728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGFE8955207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology