Provider Demographics
NPI:1528171311
Name:SPILKER, DAVID DALE (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:DALE
Last Name:SPILKER
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 1:4149 CREST RD
Mailing Address - Street 2:
Mailing Address - City:PEBBLE BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93953-3008
Mailing Address - Country:US
Mailing Address - Phone:831-624-3886
Mailing Address - Fax:
Practice Address - Street 1:245 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-2409
Practice Address - Country:US
Practice Address - Phone:831-372-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC36166207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C361660OtherBLUE CROSS
CA00C361660Medicare ID - Type Unspecified