Basic Information
| Provider Information | |||||||||
| NPI: | 1508270539 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SON | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O., M.P.H. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 145 HODENCAMP RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | THOUSAND OAKS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913605897 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 145 HODENCAMP RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | THOUSAND OAKS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913605897 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8557017955 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2014 | ||||||||
| LastUpdateDate: | 08/26/2019 | ||||||||
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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 | 204D00000X | R2982 | TX | N | Allopathic & Osteopathic Physicians | Neuromusculoskeletal Medicine & OMM | 204D00000X | 286932 | NY | N | Allopathic & Osteopathic Physicians | Neuromusculoskeletal Medicine & OMM | 204D00000X | 20A17446 | CA | N | Allopathic & Osteopathic Physicians | Neuromusculoskeletal Medicine & OMM | 207RA0401X | R2982 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | Addiction Medicine | 207RA0401X | 286932 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | Addiction Medicine | 207RA0401X | 20A17446 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Addiction Medicine |
No ID Information.