Individual
DR. CHARLES JAY DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2108 DRAKE LN, HERCULES, CA 94547-5464
(510) 837-8441
Mailing address
2108 DRAKE LN, HERCULES, CA 94547-5464
(510) 837-8441
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
31506
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111N00000X
NPI
CA
Enumeration date
05/09/2011
Last updated
05/09/2011
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