Provider Demographics
NPI:1396818282
Name:SOMMER, DAVID ANDREW (DC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ANDREW
Last Name:SOMMER
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 1:2345 ERRINGER RD STE 210
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-2250
Mailing Address - Country:US
Mailing Address - Phone:805-582-0007
Mailing Address - Fax:805-582-0003
Practice Address - Street 1:2345 ERRINGER RD STE 210
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-2250
Practice Address - Country:US
Practice Address - Phone:805-582-0007
Practice Address - Fax:805-582-0003
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24620111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU633047Medicare UPIN
U633047Medicare ID - Type Unspecified