1447463047 NPI number — DR. JOSHUA AARON DAVIDSON D.C.

Table of content: DR. JOSHUA AARON DAVIDSON D.C. (NPI 1447463047)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447463047 NPI number — DR. JOSHUA AARON DAVIDSON D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DAVIDSON
Provider First Name:
JOSHUA
Provider Middle Name:
AARON
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DAVIDSON
Provider Other First Name:
JOSHUA
Provider Other Middle Name:
AARON
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
CHIROPRACTOR
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1447463047
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/04/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9381 E STOCKTON BLVD
Provider Second Line Business Mailing Address:
LIBERTY CENTER II SUITE 219
Provider Business Mailing Address City Name:
ELK GROVE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95624-5068
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-670-1883
Provider Business Mailing Address Fax Number:
916-670-1889

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9381 E STOCKTON BLVD
Provider Second Line Business Practice Location Address:
LIBERTY CENTER II SUITE 219
Provider Business Practice Location Address City Name:
ELK GROVE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95624-5068
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-670-1883
Provider Business Practice Location Address Fax Number:
916-670-1889
Provider Enumeration Date:
05/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  DC28363 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: DC28363 . This is a "STATE LICENSE #" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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