Provider Demographics
NPI:1104963388
Name:STONE, DANIEL GERARD (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:GERARD
Last Name:STONE
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 1:17911 SKY PARK CIR
Mailing Address - Street 2:SUITE L
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-6322
Mailing Address - Country:US
Mailing Address - Phone:949-863-7086
Mailing Address - Fax:949-313-5085
Practice Address - Street 1:17911 SKY PARK CIR
Practice Address - Street 2:SUITE L
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6322
Practice Address - Country:US
Practice Address - Phone:949-863-7086
Practice Address - Fax:949-313-5085
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28538111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0285380Medicare UPIN