Dale Boyd Sparks MD

NPI 1194051581 - Allergy & Immunology - 207KA0200X

NPI Details
NPI 1194051581
Gender Male
Enumeration Date 10/20/2009
Last Updated 10/20/2009
Entity Type Individual
Active Over 7 years ago
Practice Location
29368 BIG RANGE RD
CANYON LAKE CA, 92587-7652, US
Phone (951) 244-7311
Fax (951) 244-7311
Business Location
29368 BIG RANGE RD
CANYON LAKE CA, 92587-7652, US
Phone (951) 244-7311
Fax (951) 244-7311
Toxanomy
Taxonomy Code 207KA0200X
License State California
License Number C21850
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According to our database, Dr. Dale Boyd Sparks MD NPI is 1194051581, taxonomy code is 207KA0200X and license number is C21850, license state is located at California. Dale Boyd Sparks MD physically located at 29368 Big Range Rd, Canyon Lake CA, 92587-7652. NPI Number Dale Boyd Sparks MD has the Individual type.

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1194051581 NPI number is provided on an as is basis without warranty of any kind. 1194051581 is maintained by the National Plan & Provider Enumeration System. The contents of Dale Boyd Sparks MD are for informational purposes only.