DAVID RANDALL HENDERSON NPI 1629746003

NPI Information

NPI: 1629746003
Provider Name: DAVID RANDALL HENDERSON
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

PECOS Registration: Yes

Address:
1131 WILSHIRE BLVD STE 100
SANTA MONICA, CA
ZIP 90401
Phone: (310) 319-3475
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David Randall Henderson is an acute care nurse practitioner in Santa Monica, CA with 3 years of experience. David Randall Henderson NPI is 1629746003. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1131 WILSHIRE BLVD STE 100
SANTA MONICA, CA
ZIP 90401-072
Phone: (310) 319-3475

The NPI 1629746003 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/1/2021 and was last updated on 12/13/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163W00000X	Registered Nurse		798129	CALIFORNIA	No
2	363LA2100X	Nurse Practitioner	Acute Care	95018728	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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