Provider Demographics
NPI:1861618464
Name:BALFOUR, DAVID (DC,LAC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:BALFOUR
Suffix:
Gender:M
Credentials:DC,LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 N MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-2433
Mailing Address - Country:US
Mailing Address - Phone:818-848-1205
Mailing Address - Fax:
Practice Address - Street 1:1021 N MAPLE ST
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-2433
Practice Address - Country:US
Practice Address - Phone:818-848-1205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC13442111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor