Individual
DAVID SLACK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 W EL NORTE PKWY, ESCONDIDO, CA 92026-3923
(760) 738-7830
(760) 738-7834
Mailing address
PO BOX 969096, SAN DIEGO, CA 92196-9096
(858) 495-0971
(858) 495-0991
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G36344
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G36344
MEDICAL LICENSE
CA
Enumeration date
06/15/2006
Last updated
07/08/2007
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