Provider Demographics
NPI:1124593538
Name:PASTOR, DEAN SAMUEL (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:SAMUEL
Last Name:PASTOR
Suffix:
Gender:M
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6001 BARNSIDE PL
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-9616
Mailing Address - Country:US
Mailing Address - Phone:916-348-3641
Mailing Address - Fax:
Practice Address - Street 1:6001 BARNSIDE PL
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95747-9616
Practice Address - Country:US
Practice Address - Phone:916-348-3641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-11
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist