Provider Demographics
NPI:1689756322
Name:DAVIS, DON GREGORY (DC, DACNB)
Entity Type:Individual
Prefix:DR
First Name:DON
Middle Name:GREGORY
Last Name:DAVIS
Suffix:
Gender:M
Credentials:DC, DACNB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1280 CIVIC DR STE 111
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-7208
Mailing Address - Country:US
Mailing Address - Phone:925-279-4325
Mailing Address - Fax:925-279-4322
Practice Address - Street 1:1280 CIVIC DR STE 111
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-7208
Practice Address - Country:US
Practice Address - Phone:925-279-4325
Practice Address - Fax:925-279-4322
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC13494111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT05042Medicare UPIN