1710442819 NPI number — DANIEL HOWARD VIRDIER DC

Table of content: DANIEL HOWARD VIRDIER DC (NPI 1710442819)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710442819 NPI number — DANIEL HOWARD VIRDIER DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VIRDIER
Provider First Name:
DANIEL
Provider Middle Name:
HOWARD
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1710442819
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/07/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1950 DOUGLAS BLVD STE A4
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROSEVILLE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95661-3826
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-410-9228
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7220 FAIR OAKS BLVD STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARMICHAEL
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95608-6400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-489-7246
Provider Business Practice Location Address Fax Number:
916-489-4506
Provider Enumeration Date:
02/04/2019

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1437878212 . This is a "NPI" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".