Provider Demographics
NPI:1124190038
Name:TALBOTT, JEFFREY (DC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:TALBOTT
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:PO BOX 1176
Mailing Address - Street 2:
Mailing Address - City:CARDIFF
Mailing Address - State:CA
Mailing Address - Zip Code:92007-7176
Mailing Address - Country:US
Mailing Address - Phone:858-509-7999
Mailing Address - Fax:858-509-7999
Practice Address - Street 1:3890 PROSPECT AVE STE A
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-1726
Practice Address - Country:US
Practice Address - Phone:858-509-7999
Practice Address - Fax:858-509-3993
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26817111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU81434Medicare UPIN