Provider Demographics
NPI:1619980836
Name:MCGRATH, DAVID JAMES (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:JAMES
Last Name:MCGRATH
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 1:8895 TOWNE CENTRE DR
Mailing Address - Street 2:#109
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-5542
Mailing Address - Country:US
Mailing Address - Phone:858-450-1805
Mailing Address - Fax:858-450-1986
Practice Address - Street 1:8895 TOWNE CENTRE DR
Practice Address - Street 2:#109
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-5542
Practice Address - Country:US
Practice Address - Phone:858-450-1805
Practice Address - Fax:858-450-1986
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23055111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC23055OtherLICENSE