Provider Demographics
NPI:1932129673
Name:GERARD, JAMES DOUGLAS (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DOUGLAS
Last Name:GERARD
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 1:10 W LOCUST ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95240-2136
Mailing Address - Country:US
Mailing Address - Phone:209-333-2401
Mailing Address - Fax:209-339-4589
Practice Address - Street 1:10 W LOCUST ST
Practice Address - Street 2:SUITE C
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95240-2136
Practice Address - Country:US
Practice Address - Phone:209-333-2401
Practice Address - Fax:209-339-4589
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC0155070111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor