Provider Demographics
NPI:1891873808
Name:MORGAN, DAVID FREDERICK (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:FREDERICK
Last Name:MORGAN
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 1:3400 LOMITA BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4909
Mailing Address - Country:US
Mailing Address - Phone:310-540-6908
Mailing Address - Fax:310-540-6937
Practice Address - Street 1:3400 LOMITA BLVD
Practice Address - Street 2:SUITE 128
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4900
Practice Address - Country:US
Practice Address - Phone:310-540-0965
Practice Address - Fax:310-540-6721
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG32730174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOOG327300Medicaid
CAW14194Medicare ID - Type Unspecified
CAA45266Medicare UPIN
CAWG32730DMedicare ID - Type Unspecified