Individual
DARYL J SPAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
678 3RD AVE, CHULA VISTA, CA 91910-5736
(619) 662-4100
Mailing address
678 3RD AVE, CHULA VISTA, CA 91910-5736
(619) 662-4100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101272707
VA
207Q00000X
Family Medicine Physician
Primary
A166843
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/15/2018
Last updated
06/07/2024
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