Provider Demographics
NPI:1881015188
Name:STRICK, DERRICK M (DC)
Entity Type:Individual
Prefix:DR
First Name:DERRICK
Middle Name:M
Last Name:STRICK
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 1:6577 JAFFE CT
Mailing Address - Street 2:APT. 2
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92119-2184
Mailing Address - Country:US
Mailing Address - Phone:619-335-1786
Mailing Address - Fax:
Practice Address - Street 1:5268 BALTIMORE DR
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-2080
Practice Address - Country:US
Practice Address - Phone:619-335-1786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32636111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor