Provider Demographics
NPI:1083753966
Name:PIEDA, CHRISTOPHER DONALD (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:DONALD
Last Name:PIEDA
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 1:3243 GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-1713
Mailing Address - Country:US
Mailing Address - Phone:510-846-0776
Mailing Address - Fax:
Practice Address - Street 1:711 SANTA CLARA AVE
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-3317
Practice Address - Country:US
Practice Address - Phone:510-523-5000
Practice Address - Fax:510-523-1027
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29191111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0291910Medicare ID - Type Unspecified