Provider Demographics
NPI:1760404032
Name:PITTSON, STEVEN M (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:M
Last Name:PITTSON
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 1:420 W LAS PALMAS AVE
Mailing Address - Street 2:
Mailing Address - City:PATTERSON
Mailing Address - State:CA
Mailing Address - Zip Code:95363-2542
Mailing Address - Country:US
Mailing Address - Phone:209-892-2915
Mailing Address - Fax:209-892-2938
Practice Address - Street 1:420 W LAS PALMAS AVE
Practice Address - Street 2:
Practice Address - City:PATTERSON
Practice Address - State:CA
Practice Address - Zip Code:95363-2542
Practice Address - Country:US
Practice Address - Phone:209-892-2915
Practice Address - Fax:209-892-2938
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC0175320111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT06499Medicare UPIN
CADC0175320Medicare ID - Type Unspecified