Provider Demographics
NPI:1699707844
Name:SOSINE, DENNIS (DC)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:SOSINE
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 1:2100 MONUMENT BLVD STE 7
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-3427
Mailing Address - Country:US
Mailing Address - Phone:925-676-9245
Mailing Address - Fax:
Practice Address - Street 1:2100 MONUMENT BLVD STE 7
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-3427
Practice Address - Country:US
Practice Address - Phone:925-676-9245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC14503111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC14503Medicare UPIN
CADC0145030Medicare ID - Type Unspecified