Provider Demographics
NPI:1902855406
Name:CAUBLE, DAVID HYTEN (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:HYTEN
Last Name:CAUBLE
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 1:15875 GOTHARD ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-3004
Mailing Address - Country:US
Mailing Address - Phone:714-898-6617
Mailing Address - Fax:714-893-6667
Practice Address - Street 1:15875 GOTHARD ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-3004
Practice Address - Country:US
Practice Address - Phone:714-898-6617
Practice Address - Fax:714-893-6667
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC11560111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA70458OtherDEPT OF LABOR INDUSTRIES
CADC0115600OtherBLUE SHIELD OF CALIFORNIA
OH95338276200OtherBUREAU OF WORKERS COMP
CADC11560Medicare PIN
CADC0115600OtherBLUE SHIELD OF CALIFORNIA