Provider Demographics
NPI:1144774837
Name:CEDARS, CHRIS (DC)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:CEDARS
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 4
Mailing Address - Street 2:
Mailing Address - City:NEVADA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95959-0004
Mailing Address - Country:US
Mailing Address - Phone:530-446-4574
Mailing Address - Fax:
Practice Address - Street 1:6910 DOUGLAS BLVD STE D
Practice Address - Street 2:
Practice Address - City:GRANITE BAY
Practice Address - State:CA
Practice Address - Zip Code:95746-6276
Practice Address - Country:US
Practice Address - Phone:916-597-1640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-10
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33481111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor