Healthcare Provider Details

I. General information

NPI: 1003832478
Provider Name (Legal Business Name): DAVID HENRY POBRAN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

174 S RANCHO SANTA FE RD
SAN MARCOS CA
92078-2502
US

IV. Provider business mailing address

174 S RANCHO SANTA FE RD
SAN MARCOS CA
92078-2502
US

V. Phone/Fax

Practice location:
  • Phone: 760-727-4488
  • Fax: 760-727-4412
Mailing address:
  • Phone: 760-727-4488
  • Fax: 760-727-4412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License NumberDC11499
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: