MEDICARE: DR. DAVID RESSLER D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	20362	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ZZZ56266Z	OTHER	CA	BLUE SHIELD

General Provider Information

NPI Number	:	1205826039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID RESSLER D.C.

Provider Business Mailing Address
First Line	:	1133 EL CAMINO REAL
Second Line	:	SUITE #7
City	:	SOUTH SAN FRANCISCO
State	:	CA
Zip	:	94080-3288
Country	:	US
Telephone Number	:	650-583-4080
Fax Number	:

Provider Business Practice Location Address
First Line	:	1133 EL CAMINO REAL
Second Line	:	SUITE #7
City	:	SOUTH SAN FRANCISCO
State	:	CA
Zip	:	94080-3288
Country	:	US
Telephone Number	:	650-583-4080
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2005
Last Update Date	:	02/28/2023

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