Provider Demographics
NPI:1962525709
Name:DALBY, BEVERLY JOHNSON (DC)
Entity type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:JOHNSON
Last Name:DALBY
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 1:1003 WILSHIRE BLVD
Mailing Address - Street 2:#204
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401-1927
Mailing Address - Country:US
Mailing Address - Phone:310-451-1122
Mailing Address - Fax:
Practice Address - Street 1:1003 WILSHIRE BLVD
Practice Address - Street 2:#204
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-1927
Practice Address - Country:US
Practice Address - Phone:310-451-1122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC15172111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor