Provider Demographics
NPI:1710442819
Name:VIRDIER, DANIEL HOWARD (DC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:HOWARD
Last Name:VIRDIER
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 1:1950 DOUGLAS BLVD STE A4
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3826
Mailing Address - Country:US
Mailing Address - Phone:916-410-9228
Mailing Address - Fax:
Practice Address - Street 1:7220 FAIR OAKS BLVD STE B
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-6400
Practice Address - Country:US
Practice Address - Phone:916-489-7246
Practice Address - Fax:916-489-4506
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-04
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1437878212OtherNPI