Derrell R. Tidwell in Los Angeles - Clinical
Derrell R. Tidwell - NPI 1871661074
Derrell R. Tidwell is a Clinical in Los Angeles, California. Derrell R. Tidwell practices all healthcare services and medical treatments related to Clinical. The NPI Number for Derrell R. Tidwell is 1871661074. The last update date is 2015-09-08.
Derrell R. Tidwell's current location address is Po Box 83522, Los Angeles, California. You can contact this provider via phone number 3106704295 and fax number 3106704295. The mailing address for Derrell R. Tidwell is Po Box 83522, Los Angeles, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Derrell R. Tidwell |
|---|---|
| Address | Po Box 83522, Los Angeles, California |
| Phone Number | 3106704295 |
| Fax Number | 3106704295 |
| Sole Proprietor | Y |
| Credentials | ACSW, BCD, |
NPI Number Detail
| NPI Number | 1871661074 |
|---|---|
| Provider Enumeration Date | 2006-12-04 |
| Last Updated Date | 2015-09-08 |
Provider Mailing Address Detail
| Address | Po Box 83522 |
|---|---|
| City | Los Angeles |
| State | California (CA) |
| Post Code | 900830083 |
| Phone Number | 3106704295 |
| Fax Number | 3106704295 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | LCS 9609 |
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What is the Derrell R. Tidwell's 1871661074?
The Derrell R. Tidwell's NPI (National Provider Identifier) Number is 1871661074. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Where is the Derrell R. Tidwell located?
The Derrell R. Tidwell is located at Po Box 83522, Los Angeles, CA 900830083.
What is the Derrell R. Tidwell's area of specialization and corresponding taxonomy classification?
The Derrell R. Tidwell's specialty field is Clinical, and it falls under the taxonomy code 1041C0700X, which categorizes healthcare providers based on their specialties.
When did the Derrell R. Tidwell receive its 1871661074?
The Derrell R. Tidwell was issued its 1871661074 on 2006-12-04, which is the date when the organization was assigned this unique identifier.
As of what date were the Derrell R. Tidwell's details last updated?
The information pertaining to the Derrell R. Tidwell, including its address, specialty, and other details, was most recently updated on 2015-09-08.
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