Provider Demographics
NPI:1386654366
Name:BELK, DAVID L (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:L
Last Name:BELK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2070 CLINTON AVE
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-4320
Mailing Address - Country:US
Mailing Address - Phone:510-769-7078
Mailing Address - Fax:
Practice Address - Street 1:2070 CLINTON AVE
Practice Address - Street 2:5TH FLOOR
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-4320
Practice Address - Country:US
Practice Address - Phone:510-769-7078
Practice Address - Fax:510-769-7795
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA66844207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A668440Medicaid
CA00A668440Medicaid
CAH57889Medicare UPIN