Individual
TAL DAVID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4910 DIRECTORS PL STE 350, SAN DIEGO, CA 92121-3834
(858) 571-9500
(858) 453-7314
Mailing address
4445 EASTGATE MALL STE 105, SAN DIEGO, CA 92121-1979
(858) 412-6080
(858) 412-6376
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
A69504
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W17895
MEDICARE GROUP NUMBER
—
01
—
WA69504C
MEDICARE PROVIDER ID
—
Enumeration date
07/26/2006
Last updated
07/01/2020
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