Provider Demographics
NPI:1346452695
Name:LADOW, CRAIG PETER (DC)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:PETER
Last Name:LADOW
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 1:1212 BROADWAY
Mailing Address - Street 2:SUITE 722
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-1805
Mailing Address - Country:US
Mailing Address - Phone:510-839-3330
Mailing Address - Fax:510-839-3331
Practice Address - Street 1:1212 BROADWAY
Practice Address - Street 2:SUITE 722
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-1805
Practice Address - Country:US
Practice Address - Phone:510-839-3330
Practice Address - Fax:510-839-3331
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC22747111N00000X, 111NR0400X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered111NR0400XChiropractic ProvidersChiropractorRehabilitation
Not Answered111NS0005XChiropractic ProvidersChiropractorSports Physician