Provider Demographics
NPI:1942231576
Name:BAILEY, DAVID N (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:N
Last Name:BAILEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5617 BELLEVUE AVE
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-7526
Mailing Address - Country:US
Mailing Address - Phone:619-921-8840
Mailing Address - Fax:858-454-2756
Practice Address - Street 1:200 W ARBOR DR
Practice Address - Street 2:MAIL CODE 8320
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-9001
Practice Address - Country:US
Practice Address - Phone:619-543-6386
Practice Address - Fax:619-543-3730
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG34170207ZP0104X, 207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207ZP0104XAllopathic & Osteopathic PhysiciansPathologyChemical Pathology
Not Answered207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G341700Medicaid
CA00G341700Medicaid
CAWG34170AMedicare ID - Type Unspecified