Provider Demographics
NPI:1396828232
Name:SEIFERT, STEVEN GRANT (DC)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:GRANT
Last Name:SEIFERT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:STEVEN
Other - Middle Name:G
Other - Last Name:SEIFERT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:4505 BARRANCA PKWY
Mailing Address - Street 2:#B
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4707
Mailing Address - Country:US
Mailing Address - Phone:949-551-8002
Mailing Address - Fax:949-551-1281
Practice Address - Street 1:4505 BARRANCA PKWY
Practice Address - Street 2:#B
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4707
Practice Address - Country:US
Practice Address - Phone:949-551-8002
Practice Address - Fax:949-551-1281
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC12276111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC12276OtherLICENSE NUMBER