Provider Demographics
NPI:1699547406
Name:FLYNN, DANIEL ROBERT (DC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:ROBERT
Last Name:FLYNN
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 1:6400 SUNRISE BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-5998
Mailing Address - Country:US
Mailing Address - Phone:916-727-6400
Mailing Address - Fax:916-727-3292
Practice Address - Street 1:6400 SUNRISE BLVD
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-5998
Practice Address - Country:US
Practice Address - Phone:916-727-6400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-011904111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor