Provider Demographics
NPI:1124340997
Name:STAHL, MICHAEL JAMES (DC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JAMES
Last Name:STAHL
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 1:7320 WOODLAKE AVE.
Mailing Address - Street 2:#370
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-1472
Mailing Address - Country:US
Mailing Address - Phone:818-710-0290
Mailing Address - Fax:
Practice Address - Street 1:7320 WOODLAKE AVE.
Practice Address - Street 2:#370
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-1472
Practice Address - Country:US
Practice Address - Phone:818-710-0290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC16886111N00000X, 111NI0013X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner
No111NX0800XChiropractic ProvidersChiropractorOrthopedic