MEDICARE: DR. DAVID DALE SPILKER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	C36166	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00C361660	OTHER	CA	BLUE CROSS

General Provider Information

NPI Number	:	1528171311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID DALE SPILKER M.D.

Provider Business Mailing Address
First Line	:	4149 CREST RD
Second Line	:
City	:	PEBBLE BEACH
State	:	CA
Zip	:	93953-3008
Country	:	US
Telephone Number	:	831-624-3886
Fax Number	:

Provider Business Practice Location Address
First Line	:	245 WASHINGTON ST
Second Line	:
City	:	MONTEREY
State	:	CA
Zip	:	93940-2409
Country	:	US
Telephone Number	:	831-372-2273
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2006
Last Update Date	:	07/08/2007

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