Provider Demographics
NPI:1932206083
Name:PADILLA, JAMES LAWRENCE (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LAWRENCE
Last Name:PADILLA
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 1:16870 W BERNARDO DR STE 120
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-1678
Mailing Address - Country:US
Mailing Address - Phone:858-676-1166
Mailing Address - Fax:858-676-1172
Practice Address - Street 1:16870 W BERNARDO DR STE 120
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-1678
Practice Address - Country:US
Practice Address - Phone:858-676-1166
Practice Address - Fax:858-676-1172
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2024-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23346111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1932206083OtherINDIVIDUAL NPI
CA1003955733OtherGROUP NPI
CA1932206083OtherINDIVIDUAL NPI