Provider Demographics
NPI:1679659452
Name:FLINT, MICHAEL C (DC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:C
Last Name:FLINT
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 1:3587 MEADE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92116
Mailing Address - Country:US
Mailing Address - Phone:619-283-5963
Mailing Address - Fax:619-283-5964
Practice Address - Street 1:3587 MEADE AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92116
Practice Address - Country:US
Practice Address - Phone:619-283-5963
Practice Address - Fax:619-283-5964
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21321111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA021919Medicare UPIN
CADC21321Medicare PIN