Provider Demographics
NPI:1467560862
Name:NOVAK, STEPHEN LESLIE (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:LESLIE
Last Name:NOVAK
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 1:3848 MCHENRY AVE SUITE 120
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-1582
Mailing Address - Country:US
Mailing Address - Phone:209-526-2017
Mailing Address - Fax:209-526-2849
Practice Address - Street 1:3848 MCHENRY AVE SUITE 120
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95356-1582
Practice Address - Country:US
Practice Address - Phone:209-526-2017
Practice Address - Fax:209-526-2849
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC19556111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor