Provider Demographics
NPI:1346309887
Name:SANDAHL, ADAM LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:LEE
Last Name:SANDAHL
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 1:6557 BRIGHT AVE
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90601-4504
Mailing Address - Country:US
Mailing Address - Phone:562-698-1515
Mailing Address - Fax:562-698-3535
Practice Address - Street 1:6557 E PACIFIC COAST HWY
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90803-4202
Practice Address - Country:US
Practice Address - Phone:562-430-8501
Practice Address - Fax:562-430-8591
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24587111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA26-3589026OtherEIN