Provider Demographics
NPI:1992801203
Name:MCALLISTER, DAVID RAY (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:RAY
Last Name:MCALLISTER
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:UCLA ORTHOPAEDIC SURGERY
Mailing Address - Street 2:FILE 54206
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-4206
Mailing Address - Country:US
Mailing Address - Phone:310-206-5250
Mailing Address - Fax:310-202-0831
Practice Address - Street 1:UCLA ORTHOPAEDIC SURGERY
Practice Address - Street 2:10833 LECONTE AVENUE
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-0001
Practice Address - Country:US
Practice Address - Phone:310-202-6204
Practice Address - Fax:310-202-0831
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG77516207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G775160Medicaid
CAWG77516BMedicare PIN
CAG20394Medicare UPIN