Provider Demographics
NPI:1083983621
Name:PALMES, GERALD PASADILLA (DC)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:PASADILLA
Last Name:PALMES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:GERRY
Other - Middle Name:
Other - Last Name:PALMES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:9909 MIRA MESA BLVD STE 130
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-1072
Mailing Address - Country:US
Mailing Address - Phone:619-758-5820
Mailing Address - Fax:619-344-0050
Practice Address - Street 1:9909 MIRA MESA BLVD STE 130
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-1072
Practice Address - Country:US
Practice Address - Phone:619-758-5820
Practice Address - Fax:619-344-0050
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-28
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32165111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA83-0769772Other1083983621