Healthcare Provider Details

I. General information

NPI: 1326149980
Provider Name (Legal Business Name): DAVID THOMAS FOSTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 05/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL MEDICAL CTR 34800 BOB WILSON DRIVE
SAN DIEGO CA
92134-5000
US

IV. Provider business mailing address

NAVAL MEDICAL CTR 34800 BOB WILSON DRIVE
SAN DIEGO CA
92134-5000
US

V. Phone/Fax

Practice location:
  • Phone: 619-532-0000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101242086
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: