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DR. CHARLES JAY DAVIDSON DC
>> Chiropractor >> Chiropractic ProvidersRegistrant NPI Number: 1386936441
Individual Registrant:DR. CHARLES JAY DAVIDSON DC
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
2108 DRAKE LN HERCULES, CA 94547-5464 US
Tel: 510-837-8441 Fax: --
Tel: 510-837-8441 Fax: --
Contact information for business:
2108 DRAKE LN HERCULES, CA 94547-5464 US
Tel: 510-837-8441 Fax: --
Tel: 510-837-8441 Fax: --
Registration Information:
NPI: 1386936441
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 111N00000X | Chiropractic Providers Chiropractor | CA | 31506 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| NPI | 111N00000X | CA | 01 |
