Provider Demographics
NPI:1083820997
Name:ARENSDORF, RAYMOND JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:JOSEPH
Last Name:ARENSDORF
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 1:1414 S MILLER ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-6923
Mailing Address - Country:US
Mailing Address - Phone:805-346-6700
Mailing Address - Fax:805-310-5769
Practice Address - Street 1:1414 S MILLER ST
Practice Address - Street 2:SUITE C
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-6923
Practice Address - Country:US
Practice Address - Phone:805-346-6700
Practice Address - Fax:805-310-5769
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 29438111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1062153, CHIROPRATOROtherASHN DOC ID
CA1062153, CHIROPRATOROtherASHN DOC ID
CADC29438Medicare ID - Type Unspecified