Provider Demographics
NPI:1497963938
Name:REKAR, DAVID MARK (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:MARK
Last Name:REKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 CAHUENGA BLVD W STE 208
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90068-1359
Mailing Address - Country:US
Mailing Address - Phone:323-436-0303
Mailing Address - Fax:323-436-0306
Practice Address - Street 1:4789 VINELAND AVE STE 101
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91602-3518
Practice Address - Country:US
Practice Address - Phone:323-436-0303
Practice Address - Fax:323-436-0306
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG508152081S0010X, 208D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports MedicineGroup - Single Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG48134Medicare UPIN
CAW14058Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER