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General NPI Number Information
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NPI Number | 1851437792
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Entity Type | Organization
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Legal Business Name | TAL DAVID, MD, INC
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 03/17/2010
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Provider Practice Location Address
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Address Line | 5471 KEARNY VILLA RD. SUITE 200
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City | SAN DIEGO
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State | CA
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Zip | 92123-1143
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Country | US
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Telephone | 858-571-9500
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Fax | 858-715-4946
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Provider Business Mailing Address
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Address Line | 5471 KEARNY VILLA RD. SUITE 200
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City | SAN DIEGO
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State | CA
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Zip | 92123-1143
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Country | US
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Telephone | 858-571-9500
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Fax | 858-715-4946
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Authorized Official
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Title or Position | PRESIDENT
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Name | TAL S. DAVID
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Credential | MD
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Telephone | 858-571-9500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | A69504
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License Number State | CA
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