Provider Demographics
NPI:1972554632
Name:LINCOLN, DAVID E (DC,DACNB, IDE, CCEP)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:E
Last Name:LINCOLN
Suffix:
Gender:M
Credentials:DC,DACNB, IDE, CCEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 TOWNVIEW LN
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-7538
Mailing Address - Country:US
Mailing Address - Phone:707-526-2225
Mailing Address - Fax:707-526-5267
Practice Address - Street 1:1408 TOWNVIEW LN
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-7538
Practice Address - Country:US
Practice Address - Phone:707-526-2225
Practice Address - Fax:707-526-5267
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26765111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC267650Medicare PIN