Provider Demographics
NPI:1316151160
Name:FIRMAN, WILLIAM CRAIG (DC)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CRAIG
Last Name:FIRMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:WILLIAM
Other - Middle Name:C
Other - Last Name:FIRMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:1711 W LEEWOOD STREET
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-2604
Mailing Address - Country:US
Mailing Address - Phone:909-229-1941
Mailing Address - Fax:
Practice Address - Street 1:1711 W LEEWOOD STREET
Practice Address - Street 2:IN HOME SERVICES HOUSECALLS
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-2604
Practice Address - Country:US
Practice Address - Phone:909-229-1941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC20586111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U67765Medicare ID - Type Unspecified