Provider Demographics
NPI:1336207778
Name:ALTMAN, DAVID ELLIOT (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ELLIOT
Last Name:ALTMAN
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:20 CONSTITUTION DR
Mailing Address - Street 2:SUITE #B
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-4906
Mailing Address - Country:US
Mailing Address - Phone:530-898-1100
Mailing Address - Fax:530-898-0200
Practice Address - Street 1:20 CONSTITUTION DR
Practice Address - Street 2:SUITE #B
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-4906
Practice Address - Country:US
Practice Address - Phone:530-898-1100
Practice Address - Fax:530-898-0200
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG 34377207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG 34377OtherSTATE LICENSE #
CA942691888OtherTAX ID #
CA2369933OtherPIN #
CA2369933OtherPIN #
CA45902Medicare UPIN