Washburn, Destry G

Washburn, Destry G is an individual health care provider with primary practice located at 26520 Cactus Ave , Moreno Valley CA 92555-3927. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Washburn, Destry G can be contacted via phone (951) 486-5700.

Contact Information

Primary practice address
26520 Cactus Ave Moreno Valley CA 92555-3927
Phone: (951) 486-5700
Fax: (951) 486-5705
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 20A11909 California
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 20A11909 California
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 20A11909 California

Profile Details

NPI number 1992021463
LBN Legal business name Washburn, Destry G
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 9th, 2010
Last updated Feb 16th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992021463 NPPES
California Other CA123684 PTAN

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