Provider Demographics
NPI:1801380027
Name:SCOFIELD, ADAM GAROLD JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:GAROLD JOSEPH
Last Name:SCOFIELD
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 1:1019 AUDREY AVE
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-6402
Mailing Address - Country:US
Mailing Address - Phone:408-489-6593
Mailing Address - Fax:
Practice Address - Street 1:1399 S WINCHESTER BLVD STE 140
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-4342
Practice Address - Country:US
Practice Address - Phone:408-489-6593
Practice Address - Fax:408-261-0766
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34203111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor