Provider Demographics
NPI:1215065701
Name:SADANAGA, ALFRED NORITAKA (DC)
Entity type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:NORITAKA
Last Name:SADANAGA
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 1:2200 W MAGNOLIA BLVD
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-1734
Mailing Address - Country:US
Mailing Address - Phone:818-954-0884
Mailing Address - Fax:
Practice Address - Street 1:2200 W MAGNOLIA BLVD
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-1734
Practice Address - Country:US
Practice Address - Phone:818-954-0884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC20378111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC20378Medicare ID - Type UnspecifiedCHIROPRACTIC