Provider Demographics
NPI:1205849783
Name:KNEPP, DAVID
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:KNEPP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5252 BALBOA AVE
Mailing Address - Street 2:SUITE 901
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-6906
Mailing Address - Country:US
Mailing Address - Phone:858-560-5022
Mailing Address - Fax:858-560-8092
Practice Address - Street 1:5252 BALBOA AVE
Practice Address - Street 2:SUITE 901
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-6906
Practice Address - Country:US
Practice Address - Phone:858-560-5022
Practice Address - Fax:858-560-8092
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25584111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWDC25584AMedicare ID - Type UnspecifiedDR KNEPP CHIROPRACTOR
CAW16607Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER