Healthcare Provider Details

I. General information

NPI: 1487727335
Provider Name (Legal Business Name): LEE CAMPBELL D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2489 DISCOVERY BAY BLVD SUITE 402
DISCOVERY BAY CA
94514-1011
US

IV. Provider business mailing address

2489 DISCOVERY BAY BLVD SUITE 402
DISCOVERY BAY CA
94514-1011
US

V. Phone/Fax

Practice location:
  • Phone: 925-364-2400
  • Fax:
Mailing address:
  • Phone: 925-364-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC27395
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: