Provider Demographics
NPI:1972799401
Name:DJAVID, NONA (DC)
Entity Type:Individual
Prefix:DR
First Name:NONA
Middle Name:
Last Name:DJAVID
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 NEWPORT BLVD
Mailing Address - Street 2:STE D251
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-5031
Mailing Address - Country:US
Mailing Address - Phone:949-515-4006
Mailing Address - Fax:949-515-4036
Practice Address - Street 1:1835 NEWPORT BLVD
Practice Address - Street 2:STE D251
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-5031
Practice Address - Country:US
Practice Address - Phone:949-515-4006
Practice Address - Fax:949-515-4036
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-19
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30681111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor