Provider Demographics
NPI:1043341746
Name:DAWSON, DAVID (DC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:DAWSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:DAVID
Other - Middle Name:
Other - Last Name:DAWSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:28727 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-0800
Mailing Address - Country:US
Mailing Address - Phone:310-547-4005
Mailing Address - Fax:310-547-4117
Practice Address - Street 1:28727 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275-0800
Practice Address - Country:US
Practice Address - Phone:310-547-4005
Practice Address - Fax:310-547-4117
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-25427111N00000X
CANP95000418164W00000X
CA95000418363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No164W00000XNursing Service ProvidersLicensed Practical Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily