Provider Demographics
NPI:1932283561
Name:WEST, DONNA MARIE (MD)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:MARIE
Last Name:WEST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5140 BIRCH ST
Mailing Address - Street 2:STE #100
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2169
Mailing Address - Country:US
Mailing Address - Phone:949-219-0777
Mailing Address - Fax:949-219-0778
Practice Address - Street 1:5140 BIRCH ST
Practice Address - Street 2:STE #100
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2169
Practice Address - Country:US
Practice Address - Phone:949-219-0777
Practice Address - Fax:949-219-0778
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG78962207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology