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General NPI Number Information
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NPI Number | 1952526238
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Entity Type | Organization
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Legal Business Name | RENEE M. DAVIDSON, DC A CHIROPRACTIC CORP
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 10/18/2007
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Provider Practice Location Address
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Address Line | 2107 HILLHURST AVE
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City | LOS ANGELES
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State | CA
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Zip | 90027-2003
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Country | US
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Telephone | 323-664-6003
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Fax | 323-664-8931
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Provider Business Mailing Address
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Address Line | 15550 ROCKFIELD BLVD B220
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City | IRVINE
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State | CA
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Zip | 92618-2720
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Country | US
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Telephone | 949-598-9999
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Fax | 949-598-9990
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Authorized Official
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Title or Position | PROVIDER OWNER
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Name | RENEE M DAVIDSON
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Credential | D.C.
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Telephone | 323-664-6003
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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 | DC13996
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License Number State | CA
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