Provider Demographics
NPI:1336176197
Name:CAMPBELL, DAVID CRAWFORD (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CRAWFORD
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4060 FOURTH AVENUE
Mailing Address - Street 2:SUITE 405
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-2121
Mailing Address - Country:US
Mailing Address - Phone:619-297-9131
Mailing Address - Fax:619-297-6375
Practice Address - Street 1:4060 FOURTH AVENUE
Practice Address - Street 2:SUITE 405
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2121
Practice Address - Country:US
Practice Address - Phone:619-297-9131
Practice Address - Fax:619-297-6375
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG25976207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G25976Medicaid
A42860Medicare UPIN
CA00G25976Medicaid