Provider Demographics
NPI:1841213675
Name:LOAIZA, DAVID S (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:S
Last Name:LOAIZA
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 1:27401 LOS ALTOS
Mailing Address - Street 2:SUITE 485
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6316
Mailing Address - Country:US
Mailing Address - Phone:949-831-1932
Mailing Address - Fax:949-831-1762
Practice Address - Street 1:27401 LOS ALTOS
Practice Address - Street 2:SUITE 485
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6316
Practice Address - Country:US
Practice Address - Phone:949-831-1932
Practice Address - Fax:949-831-1762
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC19518111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT88007Medicare UPIN
CADC19518Medicare ID - Type Unspecified