Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A68214 | CA |
Y | 2080A0000X | Adolescent Medicine | A68214 | CA |
N | 2080A0000X | Adolescent Medicine | MD60048703 | WA |
NPI | 1043256738 |
---|---|
Provider Name | Dr. David Jerome Inwards-Breland |
First Address | San Diego, CA 92123-4223 |
Second Address | San Diego, CA 92123-2758 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 06/05/2020 |