Provider Demographics
NPI:1215072434
Name:OBLON, DAVID JOHN (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:JOHN
Last Name:OBLON
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 1:3925 WARING RD
Mailing Address - Street 2:STE C
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-4459
Mailing Address - Country:US
Mailing Address - Phone:760-758-5770
Mailing Address - Fax:760-758-0566
Practice Address - Street 1:3925 WARING RD
Practice Address - Street 2:STE C
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-4459
Practice Address - Country:US
Practice Address - Phone:760-758-5770
Practice Address - Fax:760-758-0566
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG85016207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G850160Medicaid
D56715Medicare UPIN
CAWG85016BMedicare ID - Type Unspecified