Provider Demographics
NPI:1548537723
Name:NARITA, DAVID SUSUMU (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:SUSUMU
Last Name:NARITA
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 1:2801 CATALINA DR
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-5163
Mailing Address - Country:US
Mailing Address - Phone:916-316-0586
Mailing Address - Fax:
Practice Address - Street 1:12900 PARK PLAZA DR STE 150
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-9329
Practice Address - Country:US
Practice Address - Phone:916-206-9640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-16
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT113327207Q00000X
COCDR.0001830207Q00000X
UT12894174-1205207Q00000X
WAMD61082986207Q00000X
NV22403207Q00000X
CA55186207QH0002X
CAA055186207Q00000X
AZ67325207Q00000X
ORMD201160207Q00000X
TXT8427207Q00000X
IDMC-1495207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Single Specialty