Organization
DAVID G MADISON DC CHIROPRACTIC CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID GARY MADISON DC (OWNER/PRESIDENT)
(951) 784-7800
Entity
Organization
Contact information
Practice address
3768 JURUPA AVENUE, RIVERSIDE, CA 92506
(951) 784-7800
(951) 784-7803
Mailing address
3768 JURUPA AVE, RIVERSIDE, CA 92506-2514
(951) 784-7800
(951) 784-7803
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
DC11474
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC0114740
MEDICARE PTAN
CA
Enumeration date
12/01/2010
Last updated
01/06/2017
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