Provider Demographics
NPI:1740281179
Name:LIBS, DAVID EDWARD (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:EDWARD
Last Name:LIBS
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 1:4410 LAMONT ST.
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-4515
Mailing Address - Country:US
Mailing Address - Phone:858-483-8500
Mailing Address - Fax:858-272-0054
Practice Address - Street 1:4410 LAMONT ST.
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-4515
Practice Address - Country:US
Practice Address - Phone:858-483-8500
Practice Address - Fax:858-272-0054
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14855111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
1366565285OtherMEDICARE GROUP NPI
1366565285OtherMEDICARE GROUP NPI