Individual
DAVID PERRY MOLENCUPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
4780 SONOMA HWY, SANTA ROSA, CA 95409-4237
(707) 484-6021
(707) 539-4528
Mailing address
15550 ROCKFIELD BLVD, B220, IRVINE, CA 92618-2720
(949) 598-9999
(949) 598-9990
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
30082
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC0300820
PTAN
CA
01
—
DC30082
CHIROPRACTIC LICENSE
CA
Enumeration date
07/05/2006
Last updated
11/09/2010
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