Provider Demographics
NPI:1295766848
Name:BAUER, JASON ALAN (DC)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:ALAN
Last Name:BAUER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2356 MOORE ST
Mailing Address - Street 2:#103
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-3017
Mailing Address - Country:US
Mailing Address - Phone:619-299-9800
Mailing Address - Fax:619-299-9889
Practice Address - Street 1:2356 MOORE ST
Practice Address - Street 2:#103
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-3017
Practice Address - Country:US
Practice Address - Phone:619-299-9800
Practice Address - Fax:619-299-9889
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27584111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor