Provider Demographics
NPI:1194753798
Name:CHIVERS, NOEL MATTHEW (DC)
Entity type:Individual
Prefix:DR
First Name:NOEL
Middle Name:MATTHEW
Last Name:CHIVERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1375 BLOSSOMHILL RD
Mailing Address - Street 2:#68
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95118
Mailing Address - Country:US
Mailing Address - Phone:408-269-2225
Mailing Address - Fax:
Practice Address - Street 1:1375 BLOSSOMHILL RD
Practice Address - Street 2:#68
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95118
Practice Address - Country:US
Practice Address - Phone:408-269-2225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-27402111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor