Provider Demographics
NPI:1477584902
Name:DAVIS, STEVEN RANDALL (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:RANDALL
Last Name:DAVIS
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 1:100 E ROMIE LN
Mailing Address - Street 2:STE 4
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-3167
Mailing Address - Country:US
Mailing Address - Phone:831-757-8240
Mailing Address - Fax:831-757-1622
Practice Address - Street 1:100 E ROMIE LN
Practice Address - Street 2:STE 4
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-3167
Practice Address - Country:US
Practice Address - Phone:831-757-8240
Practice Address - Fax:831-757-1622
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC17090111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA770335180OtherTAX ID
CADC17090OtherLICENSE NUMBER