Provider Demographics
NPI:1497897441
Name:CONRAGAN, DAVID JAMES (DC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:JAMES
Last Name:CONRAGAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16375 MONTEREY ST
Mailing Address - Street 2:STE. B
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-5442
Mailing Address - Country:US
Mailing Address - Phone:408-778-3020
Mailing Address - Fax:408-778-0803
Practice Address - Street 1:16375 MONTEREY ST
Practice Address - Street 2:STE. B
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-5442
Practice Address - Country:US
Practice Address - Phone:408-778-3020
Practice Address - Fax:408-778-0803
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24796111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0247960OtherBLUE SHIELD