Provider Demographics
NPI:1255472718
Name:FLOOD, DAVID L (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:L
Last Name:FLOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4510 ALHAMBRA ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92107-4019
Mailing Address - Country:US
Mailing Address - Phone:619-517-4295
Mailing Address - Fax:
Practice Address - Street 1:3434 MIDWAY DR STE 2001
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-4924
Practice Address - Country:US
Practice Address - Phone:619-325-1161
Practice Address - Fax:619-325-1717
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009014175207X00000X
CAG52441207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ32881ZOtherBLUE SHIELD
CAGR0053000Medicaid
CAA52264Medicare UPIN
MO152360145Medicare PIN
CAGR0053000Medicaid