Provider Demographics
NPI:1124338322
Name:STAUBER, AARON J (DC)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:J
Last Name:STAUBER
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 1:1515 PALISADES DR STE N2
Mailing Address - Street 2:
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-2168
Mailing Address - Country:US
Mailing Address - Phone:310-740-6478
Mailing Address - Fax:
Practice Address - Street 1:1515 PALISADES DR STE N2
Practice Address - Street 2:
Practice Address - City:PACIFIC PALISADES
Practice Address - State:CA
Practice Address - Zip Code:90272-2168
Practice Address - Country:US
Practice Address - Phone:310-740-6478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-21
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31808111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor