Provider Demographics
NPI:1922183946
Name:BAUNE, DANIEL BERNARD (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:BERNARD
Last Name:BAUNE
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 1:1609 W 25TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90732-4301
Mailing Address - Country:US
Mailing Address - Phone:424-499-0701
Mailing Address - Fax:424-499-0702
Practice Address - Street 1:1609 W 25TH ST
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90732-4301
Practice Address - Country:US
Practice Address - Phone:424-499-0701
Practice Address - Fax:424-499-0702
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC22584111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0225840OtherBLUE SHIELD
CADC22584OtherPTAN
CADC22584OtherCHIROPRACTIC LICENSE