Provider Demographics
NPI:1932101375
Name:BARTHOLOMEW, DAVID NATHAN (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:NATHAN
Last Name:BARTHOLOMEW
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 1:4341 BIRCH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-1924
Mailing Address - Country:US
Mailing Address - Phone:949-474-2188
Mailing Address - Fax:949-474-2207
Practice Address - Street 1:4341 BIRCH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-1924
Practice Address - Country:US
Practice Address - Phone:949-474-2188
Practice Address - Fax:949-474-2207
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27720111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC27720Medicare ID - Type Unspecified