Provider Demographics
NPI:1356412050
Name:EASTHAM, DAVID V (MD, MPH)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:V
Last Name:EASTHAM
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 BODIN CIRCLE, SGQX
Mailing Address - Street 2:DEPT OF RADIATION ONCOLOGY
Mailing Address - City:TRAVIS AFB
Mailing Address - State:CA
Mailing Address - Zip Code:94535
Mailing Address - Country:US
Mailing Address - Phone:707-423-7691
Mailing Address - Fax:
Practice Address - Street 1:101 BODIN CIRCLE, SGQX
Practice Address - Street 2:DEPT OF RADIATION ONCOLOGY
Practice Address - City:TRAVIS AFB
Practice Address - State:CA
Practice Address - Zip Code:94535
Practice Address - Country:US
Practice Address - Phone:707-423-7691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA962022085R0001X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine