Provider Demographics
NPI:1801826573
Name:O'BRIEN, DENNIS MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:MICHAEL
Last Name:O'BRIEN
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 1:4408 SAN JUAN AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-6747
Mailing Address - Country:US
Mailing Address - Phone:916-965-1564
Mailing Address - Fax:916-965-3868
Practice Address - Street 1:4408 SAN JUAN AVE.
Practice Address - Street 2:SUITE 2
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628
Practice Address - Country:US
Practice Address - Phone:916-965-1564
Practice Address - Fax:916-965-3868
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19235111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor