Provider Demographics
NPI:1407862642
Name:CHAMBERS, LAWRENCE D (DC)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:D
Last Name:CHAMBERS
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 1:2670 S WHITE RD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-2071
Mailing Address - Country:US
Mailing Address - Phone:408-270-8795
Mailing Address - Fax:408-223-1970
Practice Address - Street 1:2670 S WHITE ROAD
Practice Address - Street 2:SUITE 160
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95148-2071
Practice Address - Country:US
Practice Address - Phone:408-270-8795
Practice Address - Fax:408-223-1970
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19077111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC01970770Medicare ID - Type UnspecifiedMEDICARE
CAU30994Medicare UPIN