Provider Demographics
NPI:1447318068
Name:ATENCIO, DAVID F (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:F
Last Name:ATENCIO
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 1:3188 AIRWAY AVE STE H
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-4652
Mailing Address - Country:US
Mailing Address - Phone:714-662-1921
Mailing Address - Fax:714-662-1807
Practice Address - Street 1:3188 AIRWAY AVE STE H
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-4652
Practice Address - Country:US
Practice Address - Phone:714-662-1921
Practice Address - Fax:714-432-0842
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC23200Medicare ID - Type Unspecified