Provider Demographics
NPI:1861507204
Name:BAUNE, DONALD JERRY (DC)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:JERRY
Last Name:BAUNE
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 1:25409 NARBONNE AVE
Mailing Address - Street 2:
Mailing Address - City:LOMITA
Mailing Address - State:CA
Mailing Address - Zip Code:90717-2125
Mailing Address - Country:US
Mailing Address - Phone:310-325-6210
Mailing Address - Fax:310-530-1913
Practice Address - Street 1:25409 NARBONNE AVE
Practice Address - Street 2:
Practice Address - City:LOMITA
Practice Address - State:CA
Practice Address - Zip Code:90717-2125
Practice Address - Country:US
Practice Address - Phone:310-325-6210
Practice Address - Fax:310-530-1913
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC13277111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACV133AOtherGROUP PTAN
CA1205166675OtherGROUP NPI
CACV134ZOtherINDIVIDUAL PTAN
CADC13277OtherCHIROPRACTIC LICENSE