Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | A55599 | CA |
NPI | 1063416964 |
---|---|
Provider Name | Dr. David S Hallegua |
First Address | Beverly Hills, CA 90211-2921 |
Second Address | Beverly Hills, CA 90211-2921 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2005 |
Last Update Date | 17/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A555990 | (05) | CA |
00A555990 | BLUE SHIELD (01) | CA |
954869287 | BLUE CROSS (01) | CA |
F30096 | (02) | CA |