Provider Demographics
NPI:1275605545
Name:CULLINS, WILLIAM DANIEL (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:DANIEL
Last Name:CULLINS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2940 W FLORIDA AVE
Mailing Address - Street 2:# B
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92545-3655
Mailing Address - Country:US
Mailing Address - Phone:951-925-7609
Mailing Address - Fax:951-765-1744
Practice Address - Street 1:220 S LYON AVE
Practice Address - Street 2:SUITE C
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-3851
Practice Address - Country:US
Practice Address - Phone:951-925-7609
Practice Address - Fax:951-765-1744
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC0139910111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0139910Medicaid
CADC0139910Medicaid