Healthcare Provider Details

I. General information

NPI: 1770566150
Provider Name (Legal Business Name): DAVID B. PREGERSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4002 VISTA WAY
OCEANSIDE CA
92056-4506
US

IV. Provider business mailing address

4002 VISTA WAY
OCEANSIDE CA
92056-4506
US

V. Phone/Fax

Practice location:
  • Phone: 760-940-3505
  • Fax:
Mailing address:
  • Phone: 760-724-8411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberA63493
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA63493
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: