=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306904586
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOLISTIC DOCTOR GROUP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/04/2006
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 22930 HAWTHORNE BLVD
-----------------------------------------------------
City | TORRANCE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90505
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-378-9990
-----------------------------------------------------
Fax | 310-378-1170
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 22930 HAWTHORNE BLVD
-----------------------------------------------------
City | TORRANCE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90505
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-378-9990
-----------------------------------------------------
Fax | 310-378-1170
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CLINICAL DIRECTOR
-----------------------------------------------------
Name | DR. DAVID RAYMOND DAUER
-----------------------------------------------------
Credential | DC OMD LAC CPT FIACA
-----------------------------------------------------
Telephone | 310-378-9990
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | DC 10708
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 111NR0200X
-----------------------------------------------------
Taxonomy Name | Radiology Chiropractor
-----------------------------------------------------
License Number | DC 10708
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 111NR0400X
-----------------------------------------------------
Taxonomy Name | Rehabilitation Chiropractor
-----------------------------------------------------
License Number | DC 10708
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | AC2645
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------