Provider Demographics
NPI:1982667135
Name:SPIEGEL, DAVID A (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:SPIEGEL
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 1:2067 W VISTA WAY STE 225
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92083-6001
Mailing Address - Country:US
Mailing Address - Phone:760-630-2550
Mailing Address - Fax:760-726-2305
Practice Address - Street 1:2067 W VISTA WAY STE 225
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-6001
Practice Address - Country:US
Practice Address - Phone:760-630-2550
Practice Address - Fax:760-726-2305
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG48521207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWG48521CMedicare PIN
CAG48521Medicare UPIN