Provider Demographics
NPI:1982734356
Name:HOROWITZ, DONALD (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:
Last Name:HOROWITZ
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 1990
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-8990
Mailing Address - Country:US
Mailing Address - Phone:909-625-5509
Mailing Address - Fax:909-625-5508
Practice Address - Street 1:480 N INDIAN HILL BLVD
Practice Address - Street 2:STE. A-1
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-4615
Practice Address - Country:US
Practice Address - Phone:909-625-5509
Practice Address - Fax:909-625-5508
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA228142084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A228140OtherBLUE SHIELD
CAA22814Medicare ID - Type UnspecifiedMEDICARE