Provider Demographics
NPI:1194717686
Name:RAYMAN, ANTHONY TODD (DC)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:TODD
Last Name:RAYMAN
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 1:3001 I ST 115
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-4442
Mailing Address - Country:US
Mailing Address - Phone:916-452-5055
Mailing Address - Fax:916-244-0606
Practice Address - Street 1:3001 I ST, 115
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816
Practice Address - Country:US
Practice Address - Phone:916-452-5055
Practice Address - Fax:916-244-0606
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-19
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-29525111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0295250Medicaid
CADC0295250Medicaid