Healthcare Provider Details

I. General information

NPI: 1275884603
Provider Name (Legal Business Name): DAMON WALTON D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DAMON WALTON D.C.

II. Dates (important events)

Enumeration Date: 09/25/2012
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 S BASCOM AVE STE 112
SAN JOSE CA
95128-3535
US

IV. Provider business mailing address

1210 S BASCOM AVE STE 112
SAN JOSE CA
95128-3535
US

V. Phone/Fax

Practice location:
  • Phone: 408-642-1930
  • Fax: 707-209-0907
Mailing address:
  • Phone: 408-642-1930
  • Fax: 707-209-0907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number32421
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: