Provider Demographics
NPI:1265593537
Name:TRUJILLO, DAVID J (DC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:J
Last Name:TRUJILLO
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 1:1532 US HIGHWAY 395 N STE 3
Mailing Address - Street 2:
Mailing Address - City:GARDNERVILLE
Mailing Address - State:NV
Mailing Address - Zip Code:89410-5225
Mailing Address - Country:US
Mailing Address - Phone:775-782-2910
Mailing Address - Fax:
Practice Address - Street 1:1532 US HIGHWAY 395 N STE 3
Practice Address - Street 2:
Practice Address - City:GARDNERVILLE
Practice Address - State:NV
Practice Address - Zip Code:89410-5225
Practice Address - Country:US
Practice Address - Phone:775-782-2910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB389111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor