Provider Demographics
NPI:1427342377
Name:PURDIE, DENISE RITA (MD)
Entity type:Individual
Prefix:DR
First Name:DENISE
Middle Name:RITA
Last Name:PURDIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:DENISE
Other - Middle Name:RITA
Other - Last Name:PURDIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4140 W 190TH ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-5513
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2801 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-1701
Practice Address - Country:US
Practice Address - Phone:562-933-8743
Practice Address - Fax:562-933-8744
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA122742208000000X
CAA1227422080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1427342377Medicaid