DR. DAVID JOSEPH DEROSE (NPI# 1700118700) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700118700 |
| Entity Type | Individual |
| Full Name | DR. DAVID JOSEPH DEROSE |
| Credential | MD |
| Practice Address |
20601 West Paoli Lane Weimar CA 95736-0486 |
| Mailing Address |
Po Box 486 Weimar CA 95736-0486 |
| Practice Telephone | 5306374111 |
| Practice Fax Number | 5306374443 |
| Mailing Telephone | 5306374111 |
| Mailing Fax Number | 5306374443 |
| Enumeration Date | 2010-02-02 |
| Last Update Date | 2010-02-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | G83828 | CA | Allopathic & Osteopathic Physicians |
| N | 2083P0500X |
Preventive Medicine Specialization: Preventive Medicine/Occupational Environmental Medicine |
G83828 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992814073 | David Peter Derose | Optometrist | 150 W Hillcrest Dr, Bloomsburg, PA 17815-6710 | 2006-08-30 |
| Street Address |
20601 WEST PAOLI LANE |
| City | WEIMAR |
| State | CA |
| Zip Code | 95736-0486 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083793947 | Clarence Sinn Fook Ing | Ophthalmology | 20601 West Paoli Lane, Weimar, CA 95736-0486 | 2006-11-03 |
| 1710446133 | Samantha Abbade | Nurse Practitioner | 20601 West Paoli Lane, Weimar, CA 95736 | 2019-03-15 |
| 1588072698 | Newstart Medical Group Inc | Clinic/Center | 20601 West Paoli Lane, Weimar, CA 95736-0486 | 2014-08-01 |
| 1356688329 | Benjamin Tiffany | Massage Therapist | 20601 West Paoli Lane, Weimar, CA 95736 | 2013-01-11 |
| 1245380229 | Grace Reiko Lossev | Physical Therapist | 20601 West Paoli Lane, Weimar, CA 95736 | 2007-01-11 |
| 1508927344 | Newstart Medical Clinic | Family Medicine | 20601 West Paoli Lane, Weimar, CA 95736 | 2006-12-13 |
| 1073692943 | Michael John Orlich | Family Medicine | 20601 West Paoli Lane, Weimar, CA 95736 | 2006-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407355126 | Theresa G Leal | Social Worker | 20601 W. Paoli Ln., Weimar, CA 95736 | 2018-02-08 |
| 1396176202 | Brian Glass | Nurse Practitioner | 20601 W. Paoli Lane, Weimar, CA 95736 | 2013-12-02 |
| 1538248497 | Richard Harold Lukens | Family Medicine | 20601 W Paoli Ln, Weimar, CA 95736 | 2006-11-03 |
| 1417321928 | Mariana Bria | Physician Assistant | 20601 West Paoli Ln, Weimar, CA 95736-0486 | 2015-11-20 |
| 1992745079 | Randall L Steffens Sr. | Emergency Medicine | 20601 W Paoli Ln, Weimar, CA 95736-0486 | 2006-06-07 |
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.