Provider Demographics
NPI:1356454508
Name:FUNK, PAUL DONALD (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:DONALD
Last Name:FUNK
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 1:899 GRAY AVE
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-3635
Mailing Address - Country:US
Mailing Address - Phone:530-300-1000
Mailing Address - Fax:
Practice Address - Street 1:899 GRAY AVE
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-3635
Practice Address - Country:US
Practice Address - Phone:530-300-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 12407111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor