Provider Demographics
NPI:1154317253
Name:HINKENS, MICHAEL DELANEY (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DELANEY
Last Name:HINKENS
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 1:115 E HICKORY AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-7274
Mailing Address - Country:US
Mailing Address - Phone:805-735-8148
Mailing Address - Fax:805-736-9873
Practice Address - Street 1:115 E HICKORY AVE
Practice Address - Street 2:SUITE A
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-7274
Practice Address - Country:US
Practice Address - Phone:805-735-8148
Practice Address - Fax:805-736-9873
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-23
Last Update Date:2013-08-13
Deactivation Date:2006-03-24
Deactivation Code:
Reactivation Date:2006-04-21
Provider Licenses
StateLicense IDTaxonomies
CADC21364111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC21364Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
CAU38345Medicare UPIN
CA000109014Medicare ID - Type UnspecifiedMEDICARE SUBMITTER NUMBER