Healthcare Provider Details

I. General information

NPI: 1235203092
Provider Name (Legal Business Name): PAYNTON & PAYNTON CHIROPRACTIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1414 MARIA LN
WALNUT CREEK CA
94596-5313
US

IV. Provider business mailing address

1414 MARIA LN
WALNUT CREEK CA
94596-5313
US

V. Phone/Fax

Practice location:
  • Phone: 925-938-7767
  • Fax: 925-938-7766
Mailing address:
  • Phone: 925-938-7767
  • Fax: 925-938-7766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberDC-24552
License Number StateCA

VIII. Authorized Official

Name: DR. EARLE F PAYNTON III
Title or Position: OWNER
Credential: D.C.
Phone: 925-938-7767