Provider Demographics
NPI:1417975046
Name:DILLIARD, JAMES CHRISTOPHER (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CHRISTOPHER
Last Name:DILLIARD
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 1:531 N MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-3608
Mailing Address - Country:US
Mailing Address - Phone:619-447-2651
Mailing Address - Fax:619-447-2493
Practice Address - Street 1:531 N MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-3608
Practice Address - Country:US
Practice Address - Phone:619-447-2651
Practice Address - Fax:619-447-2493
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15908111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA15908Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
CADC15908Medicare PIN