Provider Demographics
NPI:1194783514
Name:BREWER, DAVID K (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:K
Last Name:BREWER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7368
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92863-7368
Mailing Address - Country:US
Mailing Address - Phone:714-571-5000
Mailing Address - Fax:714-571-5055
Practice Address - Street 1:7304 E DEER VALLEY RD
Practice Address - Street 2:SUITE #105
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-7450
Practice Address - Country:US
Practice Address - Phone:480-264-2400
Practice Address - Fax:480-264-2410
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ187932085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0324990OtherBCBS
AZ1Z7049OtherHEALTHNET
AZ372988OtherAHCCCS
AZA03800Medicare UPIN
AZAZ0324990OtherBCBS
AZZ133433Medicare PIN
AZ372988OtherAHCCCS