Provider Demographics
NPI:1841234994
Name:PATRICK, CHAD MITCHELL (DC)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:MITCHELL
Last Name:PATRICK
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 1:205 S EL CAMINO REAL
Mailing Address - Street 2:SUITE G
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-4141
Mailing Address - Country:US
Mailing Address - Phone:760-942-7441
Mailing Address - Fax:760-942-6526
Practice Address - Street 1:205 S EL CAMINO REAL
Practice Address - Street 2:SUITE G
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-4141
Practice Address - Country:US
Practice Address - Phone:760-942-7441
Practice Address - Fax:760-942-6526
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-30164111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor