Provider Demographics
NPI:1073625349
Name:DAWSON, JOHN D (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:DAWSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 N 1ST ST
Mailing Address - Street 2:#134
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-3900
Mailing Address - Country:US
Mailing Address - Phone:559-432-5560
Mailing Address - Fax:559-432-5033
Practice Address - Street 1:6700 N 1ST ST
Practice Address - Street 2:#134
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-3900
Practice Address - Country:US
Practice Address - Phone:559-432-5560
Practice Address - Fax:559-432-5033
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19749111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADCO19749OMedicare ID - Type Unspecified