Provider Demographics
NPI:1124119367
Name:SITZMANN, DANIEL R (DC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:R
Last Name:SITZMANN
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 1:15520 ROCKFIELD BLVD A200
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-6705
Mailing Address - Country:US
Mailing Address - Phone:949-598-9999
Mailing Address - Fax:949-598-9990
Practice Address - Street 1:3118 CLAYTON RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94519-2733
Practice Address - Country:US
Practice Address - Phone:925-825-2300
Practice Address - Fax:925-825-8056
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC14501111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC14501OtherCHIROPRACTIC LICENSE
CADC0145010OtherPTAN
CADC0145010OtherBS PIN