Provider Demographics
NPI:1225190390
Name:TUNNELL, STEVEN J (DC, DACBSP, QME,)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:J
Last Name:TUNNELL
Suffix:
Gender:M
Credentials:DC, DACBSP, QME,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4328 SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CA
Mailing Address - Zip Code:91020-1132
Mailing Address - Country:US
Mailing Address - Phone:818-957-2834
Mailing Address - Fax:
Practice Address - Street 1:13600 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-5046
Practice Address - Country:US
Practice Address - Phone:818-990-3084
Practice Address - Fax:818-990-3467
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22876111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician