Provider Demographics
NPI:1457389918
Name:HORWITZ, DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:HORWITZ
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:PO BOX 31218
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-0218
Mailing Address - Country:US
Mailing Address - Phone:626-457-5839
Mailing Address - Fax:
Practice Address - Street 1:1520 SAN PABLO ST
Practice Address - Street 2:SUITE 1000
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-5310
Practice Address - Country:US
Practice Address - Phone:626-457-5839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG43389207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G433890Medicaid
CAW11675OtherGROUP MEDICARE PIN
CAZZZ50018ZOtherGROUP BLUE SHIELD
CA00G433890OtherBLUE SHIELD
CA1356390009OtherGROUP NPI
CA06E2774OtherGROUP CHAMPUS
CACE1617OtherGROUP RAILROAD MEDICARE
CAGR0016910OtherGROUP MEDICAID PIN
CAGR0016910OtherGROUP MEDICAID PIN
CA00G433890Medicaid