Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | 2013-02073 | NC |
NPI | 1144458241 |
---|---|
Provider Name | Dr. David Michael Rasmussen |
First Address | San Diego, CA 92128-4762 |
Second Address | San Diego, CA 92134-1098 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2009 |
Last Update Date | 19/05/2021 |