Provider Demographics
NPI:1407994718
Name:CARLSON, DAVID ALAN (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ALAN
Last Name:CARLSON
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 1:4890 TOPANGA CYN BLVD
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-4229
Mailing Address - Country:US
Mailing Address - Phone:818-347-9126
Mailing Address - Fax:
Practice Address - Street 1:4890 TOPANGA CYN BLVD
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-4229
Practice Address - Country:US
Practice Address - Phone:818-347-9126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26356111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor