Provider Demographics
NPI:1407179310
Name:DARNALL AND ASSOCIATES
Entity Type:Organization
Organization Name:DARNALL AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EDGAR
Authorized Official - Last Name:DARNALL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:209-462-2759
Mailing Address - Street 1:2308 N CALIFORNIA ST
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95204-5506
Mailing Address - Country:US
Mailing Address - Phone:209-462-2759
Mailing Address - Fax:
Practice Address - Street 1:2308 N CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-5506
Practice Address - Country:US
Practice Address - Phone:209-462-2759
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-05
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15173111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC 0151730OtherMEDICARE ID
T-05659Medicare UPIN