Provider Demographics
NPI:1730130287
Name:DAVID, ROY AARON (MD)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:AARON
Last Name:DAVID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ROY
Other - Middle Name:
Other - Last Name:AMIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3252 HOLIDAY COURT
Mailing Address - Street 2:SUITE: 206
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037
Mailing Address - Country:US
Mailing Address - Phone:858-658-0595
Mailing Address - Fax:858-658-0596
Practice Address - Street 1:3252 HOLIDAY COURT
Practice Address - Street 2:SUITE: 206
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037
Practice Address - Country:US
Practice Address - Phone:858-658-0595
Practice Address - Fax:858-658-0596
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA81051207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH63418Medicare UPIN
CAA81051Medicare ID - Type Unspecified