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General NPI Number Information
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NPI Number | 1881766897
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Entity Type | Individual
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Provider Name | DARRELL STEPHEN LAVIN D.C.
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Gender | Male
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 20995 REDWOOD RD
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-5919
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Country | US
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Telephone | 510-727-0660
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Fax | 510-727-1880
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Provider Business Mailing Address
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Address Line | 3529 ARCADIAN CT
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-1118
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Country | US
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Telephone | 510-538-5829
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 19889
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License Number State | CA
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