Provider Demographics
NPI:1831166651
Name:DALLAFIOR, DAVID ERNEST (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ERNEST
Last Name:DALLAFIOR
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 1:465 10TH ST
Mailing Address - Street 2:#305
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-4363
Mailing Address - Country:US
Mailing Address - Phone:504-669-3744
Mailing Address - Fax:
Practice Address - Street 1:465 10TH ST
Practice Address - Street 2:#305
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-4363
Practice Address - Country:US
Practice Address - Phone:504-669-3744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAL025369207P00000X
CAA93975207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1575194Medicaid
LA1575194Medicaid
H61548Medicare UPIN