Healthcare Provider Details

I. General information

NPI: 1275603607
Provider Name (Legal Business Name): JASON MORRISON D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 09/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 CAMINO DEL RIO S 106
SAN DIEGO CA
92108-3530
US

IV. Provider business mailing address

411 CAMINO DEL RIO S 106
SAN DIEGO CA
92108-3530
US

V. Phone/Fax

Practice location:
  • Phone: 619-295-0077
  • Fax: 619-295-2552
Mailing address:
  • Phone: 619-295-0077
  • Fax: 619-295-2552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC29269
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: