Provider Demographics
NPI:1124030176
Name:ADAMS, DAVID CHARLES (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CHARLES
Last Name:ADAMS
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 1:1500 LOS PADRES BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-4462
Mailing Address - Country:US
Mailing Address - Phone:408-247-4640
Mailing Address - Fax:408-247-2187
Practice Address - Street 1:1500 LOS PADRES BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-4462
Practice Address - Country:US
Practice Address - Phone:408-247-4640
Practice Address - Fax:408-247-2187
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC19035111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU94914Medicare UPIN
CADC0190350Medicare ID - Type UnspecifiedPROVIDER ID NUMBER