| David G Madison Dc Chiropractic Corporation | |
|
3768 Jurupa Avenue Riverside CA 92506 | |
| (951) 784-7800 | |
| (951) 784-7803 |
| Full Name | David G Madison Dc Chiropractic Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 3768 Jurupa Avenue, Riverside, California |
| Authorized Official Name and Position | David Gary Madison (OWNER/PRESIDENT) |
| Authorized Official Contact | 9517847800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David G Madison Dc Chiropractic Corporation 3768 Jurupa Ave Riverside CA 92506-2514 Ph: (951) 784-7800 | David G Madison Dc Chiropractic Corporation 3768 Jurupa Avenue Riverside CA 92506 Ph: (951) 784-7800 |
| NPI Number | 1841592532 |
|---|---|
| Provider Enumeration Date | 12/01/2010 |
| Last Update Date | 01/06/2017 |
| Medicare PECOS PAC ID | 9537105697 |
|---|---|
| Medicare Enrollment ID | O20050629000844 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841592532 | NPI | - | NPPES |
| DC0114740 | Other | CA | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | DC11474 (California) | Primary |
| Provider Name | David Madison |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1508873803 PECOS PAC ID: 6901064419 Enrollment ID: I20120229000522 |
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