Provider Demographics
NPI:1598089013
Name:RASMUSSEN, STEPHEN GREGORY (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:GREGORY
Last Name:RASMUSSEN
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 1:100 WEST AMERICAN CANYON RD STE-K6
Mailing Address - Street 2:
Mailing Address - City:AMERICAN CANYON
Mailing Address - State:CA
Mailing Address - Zip Code:94503-1083
Mailing Address - Country:US
Mailing Address - Phone:707-864-2223
Mailing Address - Fax:707-638-3534
Practice Address - Street 1:100 WEST AMERICAN CANYON RD STE - K6
Practice Address - Street 2:
Practice Address - City:AMERICAN CANYON
Practice Address - State:CA
Practice Address - Zip Code:94503-1083
Practice Address - Country:US
Practice Address - Phone:707-864-2223
Practice Address - Fax:707-638-3534
Is Sole Proprietor?:No
Enumeration Date:2010-03-26
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14205111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor