Provider Demographics
NPI:1558585703
Name:GOMBAR, DAVID EDWARD (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:EDWARD
Last Name:GOMBAR
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 1:75 OLD CLAIRTON ROAD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236-3916
Mailing Address - Country:US
Mailing Address - Phone:412-653-3233
Mailing Address - Fax:
Practice Address - Street 1:75 OLD CLAIRTON ROAD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15236-3916
Practice Address - Country:US
Practice Address - Phone:412-653-3233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC001480L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T29889Medicare UPIN
G0159875Medicare ID - Type Unspecified