Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | A127805 | CA |
NPI | 1083977227 |
---|---|
Provider Name | David Charles Mcclaskey |
First Address | San Diego, CA 92154-8404 |
Second Address | San Diego, CA 92154-8404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2012 |
Last Update Date | 30/11/2021 |