Provider Demographics
NPI:1154412427
Name:WEISBECKER, DANIEL BRIAN (DC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:BRIAN
Last Name:WEISBECKER
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 1:94-1030 WAIPIO UKA ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-4084
Mailing Address - Country:US
Mailing Address - Phone:808-671-7887
Mailing Address - Fax:808-671-7887
Practice Address - Street 1:94-1030 WAIPIO UKA ST
Practice Address - Street 2:SUITE 104
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-4084
Practice Address - Country:US
Practice Address - Phone:808-671-7887
Practice Address - Fax:808-671-7887
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI799111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI216655OtherHMSA
HI51899Medicare ID - Type Unspecified
V06859Medicare UPIN