Individual
DAVID R. HACKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9850 GENESEE AVE., SUITE 210, LA JOLLA, CA 92037-1244
(858) 535-1075
(858) 453-9810
Mailing address
9850 GENESEE AVE., SUITE 210, LA JOLLA, CA 92037-1244
(858) 535-1075
(858) 453-9810
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
G75801
CA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
G75801
CA
207XX0801X
Orthopaedic Trauma Physician
Primary
G75801
CA
Other
Enumeration date
07/17/2006
Last updated
05/06/2015
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