Basic Information
| Provider Information | |||||||||
| NPI: | 1053481804 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DAVID | ||||||||
| FirstName: | FLOYD | ||||||||
| MiddleName: | CARLTON | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4156 MANZANITA AVE | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | CARMICHAEL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956081726 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9164835400 | ||||||||
| FaxNumber: | 1964831937 | ||||||||
| Practice Location | |||||||||
| Address1: | 4112 E COMMERCE WAY | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95834 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9164476337 | ||||||||
| FaxNumber: | 9164831937 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/09/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | G70084 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.