Provider Demographics
NPI:1982082830
Name:MASON, DAVID R (DC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:R
Last Name:MASON
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 1:1140 MANGROVE AVE
Mailing Address - Street 2:STE C
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-3500
Mailing Address - Country:US
Mailing Address - Phone:530-345-3043
Mailing Address - Fax:530-345-2104
Practice Address - Street 1:1140 MANGROVE AVE
Practice Address - Street 2:STE C
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-3500
Practice Address - Country:US
Practice Address - Phone:530-345-3043
Practice Address - Fax:530-345-2104
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-12
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32999111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor