Provider Demographics
NPI:1427083039
Name:OTTMAN, DAVID W (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:W
Last Name:OTTMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6660 COYLE AVENUE
Mailing Address - Street 2:STE 270
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608
Mailing Address - Country:US
Mailing Address - Phone:916-961-0497
Mailing Address - Fax:916-961-5736
Practice Address - Street 1:6660 COYLE AVENUE
Practice Address - Street 2:STE 270
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608
Practice Address - Country:US
Practice Address - Phone:916-961-0497
Practice Address - Fax:916-961-5736
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2008-05-08
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Provider Licenses
StateLicense IDTaxonomies
CAA30377207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A303770Medicaid
CA756183902Medicare PIN
CA00A303770Medicare PIN
CA00A303770Medicaid