Provider Demographics
NPI:1053486092
Name:MURPHY, DANIEL JERALD (DC)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:JERALD
Last Name:MURPHY
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 1:519 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-5176
Mailing Address - Country:US
Mailing Address - Phone:805-925-4569
Mailing Address - Fax:805-925-4261
Practice Address - Street 1:519 S BROADWAY
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-5176
Practice Address - Country:US
Practice Address - Phone:805-925-4569
Practice Address - Fax:805-925-4261
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC19675111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC19675Medicare ID - Type Unspecified