Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | G27861 | CA |
N | 207ND0101X | MOHS-Micrographic Surgeon | G27861 | CA |
N | 207ND0900X | Dermatopathologist | G27861 | CA |
N | 207NS0135X | Procedural Dermatology | G27861 | CA |
NPI | 1225045438 |
---|---|
Provider Name | David Charles Rish |
First Address | Beverly Hills, CA 90210-5027 |
Second Address | Beverly Hills, CA 90210-5027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 08/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A43524 | (02) | CA |