Provider Demographics
NPI:1942216536
Name:CANTONG, DAVID ENRIQUE (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ENRIQUE
Last Name:CANTONG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:17750 SHERMAN WAY
Mailing Address - Street 2:#300
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-3380
Mailing Address - Country:US
Mailing Address - Phone:818-705-7200
Mailing Address - Fax:818-343-0805
Practice Address - Street 1:1711 W TEMPLE ST
Practice Address - Street 2:#4100
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-5421
Practice Address - Country:US
Practice Address - Phone:213-380-6393
Practice Address - Fax:213-380-2936
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC21916111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor