Provider Demographics
NPI:1851503965
Name:STALZER, PAMELA (DC)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:STALZER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23111 VENTURA BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1159
Mailing Address - Country:US
Mailing Address - Phone:818-223-8702
Mailing Address - Fax:818-223-8790
Practice Address - Street 1:23111 VENTURA BLVD STE 203
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-1159
Practice Address - Country:US
Practice Address - Phone:818-223-8702
Practice Address - Fax:818-223-8790
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC15261111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC15261Medicare UPIN