Provider Demographics
NPI:1518186162
Name:DAVID R PLOTNER M.D. APC
Entity Type:Organization
Organization Name:DAVID R PLOTNER M.D. APC
Other - Org Name:DBA EYE SPECIALISTS OF ESCONDIDO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:R
Authorized Official - Last Name:KIRK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-489-5100
Mailing Address - Street 1:201 W VALLEY PKWY
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-2608
Mailing Address - Country:US
Mailing Address - Phone:760-489-5100
Mailing Address - Fax:760-489-6567
Practice Address - Street 1:201 W VALLEY PKWY
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-2608
Practice Address - Country:US
Practice Address - Phone:760-489-5100
Practice Address - Fax:760-489-6567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG25905207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA180005403OtherRAILROAD MEDICARE
CA180005403OtherRAILROAD MEDICARE
CAA42827Medicare UPIN
CA0766720001Medicare NSC
CA180005403OtherRAILROAD MEDICARE
CA00G259050Medicaid