Provider Demographics
NPI:1336250224
Name:VACA VALLEY CHIROPRACTIC DAVID LAMB D.C.,SEAN MOFFETT D.C., INC.
Entity Type:Organization
Organization Name:VACA VALLEY CHIROPRACTIC DAVID LAMB D.C.,SEAN MOFFETT D.C., INC.
Other - Org Name:VACA VALLEY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:D.C.
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:MOFFETT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:707-447-9885
Mailing Address - Street 1:97 DOBBINS ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-4298
Mailing Address - Country:US
Mailing Address - Phone:707-447-9885
Mailing Address - Fax:707-447-7372
Practice Address - Street 1:97 DOBBINS ST
Practice Address - Street 2:SUITE A
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-4298
Practice Address - Country:US
Practice Address - Phone:707-447-9885
Practice Address - Fax:707-447-7372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA31483Medicare UPIN