Provider Demographics
NPI:1275603607
Name:MORRISON, JASON (DC)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:MORRISON
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 1:411 CAMINO DEL RIO S
Mailing Address - Street 2:106
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3530
Mailing Address - Country:US
Mailing Address - Phone:619-295-0077
Mailing Address - Fax:619-295-2552
Practice Address - Street 1:411 CAMINO DEL RIO S
Practice Address - Street 2:106
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3530
Practice Address - Country:US
Practice Address - Phone:619-295-0077
Practice Address - Fax:619-295-2552
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29269111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAV08919Medicare UPIN