Provider Demographics
NPI:1013308675
Name:SOSA, DAVID SALVATORE (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:SALVATORE
Last Name:SOSA
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 1:2250 CAMINO DE LA REINA UNIT 204
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-5519
Mailing Address - Country:US
Mailing Address - Phone:716-998-4239
Mailing Address - Fax:
Practice Address - Street 1:531 ENCINITAS BLVD
Practice Address - Street 2:#100
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-3741
Practice Address - Country:US
Practice Address - Phone:760-753-2157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-17
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33150111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor