Provider Demographics
NPI:1841387131
Name:GITHLER, FREDERICK (DC)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:
Last Name:GITHLER
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 1:95 ARGONAUT
Mailing Address - Street 2:280
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-4133
Mailing Address - Country:US
Mailing Address - Phone:949-598-9999
Mailing Address - Fax:949-598-9990
Practice Address - Street 1:5245 COLLEGE AVE
Practice Address - Street 2:803
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1414
Practice Address - Country:US
Practice Address - Phone:510-325-1062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23818111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0238180OtherBLUE SHIELD
CAU57863Medicare UPIN
CADC0238180Medicare ID - Type Unspecified