Provider Demographics
NPI:1386854222
Name:NORGAARD, DAVID (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:NORGAARD
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 1:540 SESPE AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FILLMORE
Mailing Address - State:CA
Mailing Address - Zip Code:93015-1943
Mailing Address - Country:US
Mailing Address - Phone:805-524-3755
Mailing Address - Fax:805-524-7105
Practice Address - Street 1:540 SESPE AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:FILLMORE
Practice Address - State:CA
Practice Address - Zip Code:93015-1943
Practice Address - Country:US
Practice Address - Phone:805-524-3755
Practice Address - Fax:805-524-7105
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC13629111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC13629Medicare ID - Type Unspecified