Provider Demographics
NPI:1124168034
Name:DIX, DAVID O (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:O
Last Name:DIX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5501 S CORNING AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90056-1302
Mailing Address - Country:US
Mailing Address - Phone:310-410-4658
Mailing Address - Fax:323-292-5611
Practice Address - Street 1:12021 WILMINGTON AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90059-3019
Practice Address - Country:US
Practice Address - Phone:310-668-4658
Practice Address - Fax:323-292-5611
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA53041207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology