Provider Demographics
NPI:1558499277
Name:POLLENZ, ADAM SCOTT (DC)
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:SCOTT
Last Name:POLLENZ
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 1:1984 OLD MISSION DR STE A1
Mailing Address - Street 2:
Mailing Address - City:SOLVANG
Mailing Address - State:CA
Mailing Address - Zip Code:93463-2273
Mailing Address - Country:US
Mailing Address - Phone:805-693-1811
Mailing Address - Fax:805-693-0411
Practice Address - Street 1:1984 OLD MISSION DR STE A1
Practice Address - Street 2:
Practice Address - City:SOLVANG
Practice Address - State:CA
Practice Address - Zip Code:93463-2273
Practice Address - Country:US
Practice Address - Phone:805-693-1811
Practice Address - Fax:805-693-0411
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25369111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWDC25369AMedicare ID - Type UnspecifiedMEDICARE ID