Basic Information
Provider Information
NPI: 1396276861
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MACPHERSON
FirstName: DAVID
MiddleName: THOMAS
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
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Mailing Information
Address1: 5767 W CENTURY BLVD STE 400
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900455631
CountryCode: US
TelephoneNumber: 3103018707
FaxNumber:  
Practice Location
Address1: 625 S FAIR OAKS AVE STE 280
Address2:  
City: PASADENA
State: CA
PostalCode: 911052670
CountryCode: US
TelephoneNumber: 6268174747
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/25/2017
LastUpdateDate: 08/05/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/05/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207W00000XA172838CAY Allopathic & Osteopathic PhysiciansOphthalmology 

No ID Information.


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