Provider Demographics
NPI:1154562700
Name:SLONE, DANIEL SHAWN (DC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:SHAWN
Last Name:SLONE
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 1:4588 PERALTA BLVD.
Mailing Address - Street 2:SUITE #7
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536
Mailing Address - Country:US
Mailing Address - Phone:510-793-4835
Mailing Address - Fax:
Practice Address - Street 1:4588 PERALTA BLVD
Practice Address - Street 2:SUITE #7
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-5757
Practice Address - Country:US
Practice Address - Phone:510-793-4835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-11
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28172111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician