Individual
DARRYL A BATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9333 GENESEE AVE STE 200, LA JOLLA FAMILY AND SPORTS MEDICINE, SAN DIEGO, CA 92121-2113
(858) 657-8525
Mailing address
8575 GIBBS DR STE 202, UCSD MEDICAL GROUP, MAIL CODE 8201, SAN DIEGO, CA 92123-1773
(619) 543-1899
(619) 543-3183
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
EC081067
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
433017499
—
ME
Enumeration date
07/14/2008
Last updated
02/13/2023
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