Provider Demographics
NPI:1083886139
Name:ANNA MARIA DAVID M.D. INC
Entity Type:Organization
Organization Name:ANNA MARIA DAVID M.D. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANNA MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-475-1261
Mailing Address - Street 1:PO BOX 785
Mailing Address - Street 2:
Mailing Address - City:BONITA
Mailing Address - State:CA
Mailing Address - Zip Code:91908-0785
Mailing Address - Country:US
Mailing Address - Phone:619-475-1261
Mailing Address - Fax:619-475-1267
Practice Address - Street 1:502 EUCLID AVE
Practice Address - Street 2:SUITE #200
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-2931
Practice Address - Country:US
Practice Address - Phone:619-475-1261
Practice Address - Fax:619-475-1267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA61522207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G46794Medicare UPIN
CAA61522Medicare PIN