Provider Demographics
NPI:1962520403
Name:DAVIDSON, BETH DAVIS (DC)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:DAVIS
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2718 TELEGRAPH AVE
Mailing Address - Street 2:STE 103
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705
Mailing Address - Country:US
Mailing Address - Phone:510-845-8201
Mailing Address - Fax:510-849-1808
Practice Address - Street 1:2718 TELEGRAPH AVE
Practice Address - Street 2:STE 103
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705
Practice Address - Country:US
Practice Address - Phone:510-845-8201
Practice Address - Fax:510-849-1808
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20560111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U51600Medicare UPIN