Provider Demographics
NPI:1144394974
Name:WATSON, DANIEL O'NEIL (DC)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:O'NEIL
Last Name:WATSON
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 1:20415 SUNNY RIDGE LN # B
Mailing Address - Street 2:
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370-9425
Mailing Address - Country:US
Mailing Address - Phone:209-532-7535
Mailing Address - Fax:209-532-7535
Practice Address - Street 1:20415 SUNNY RIDGE LN # B
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-9425
Practice Address - Country:US
Practice Address - Phone:209-532-7535
Practice Address - Fax:209-532-7535
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26510111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor