Provider Demographics
NPI:1114074994
Name:ATKINSON, DAVID CHARLES (DC, QME)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CHARLES
Last Name:ATKINSON
Suffix:
Gender:M
Credentials:DC, QME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2245 MORELLO AVE STE B
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-1884
Mailing Address - Country:US
Mailing Address - Phone:925-287-9300
Mailing Address - Fax:925-746-7780
Practice Address - Street 1:2245 MORELLO AVE STE B
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-1884
Practice Address - Country:US
Practice Address - Phone:925-287-9300
Practice Address - Fax:925-746-7780
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13275111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT04948Medicare UPIN
CADC0132750Medicare ID - Type UnspecifiedPROVIDER #