Provider Demographics
NPI:1255522173
Name:BULLOCK, DAVID ALBAN (DC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ALBAN
Last Name:BULLOCK
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 1:25000 PLAZA LARIOS
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-3009
Mailing Address - Country:US
Mailing Address - Phone:818-723-9111
Mailing Address - Fax:818-899-8712
Practice Address - Street 1:13466 OSBORNE ST
Practice Address - Street 2:
Practice Address - City:ARLETA
Practice Address - State:CA
Practice Address - Zip Code:91331-5522
Practice Address - Country:US
Practice Address - Phone:818-899-2591
Practice Address - Fax:818-899-8712
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29938111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor