Provider Demographics
NPI:1831136712
Name:FOSTER, DAVID SIDNEY (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:SIDNEY
Last Name:FOSTER
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 1:6740 VESPER AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-4612
Mailing Address - Country:US
Mailing Address - Phone:818-782-5223
Mailing Address - Fax:818-782-5221
Practice Address - Street 1:6740 VESPER AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-4612
Practice Address - Country:US
Practice Address - Phone:818-782-5223
Practice Address - Fax:818-782-5221
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC9922111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC9922AMedicare ID - Type Unspecified
CAT19037Medicare UPIN