Provider Demographics
NPI:1952309601
Name:MARXEN, DENIS MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:DENIS
Middle Name:MICHAEL
Last Name:MARXEN
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 1:13867 FOOTHILL BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-3008
Mailing Address - Country:US
Mailing Address - Phone:818-364-2323
Mailing Address - Fax:818-364-5460
Practice Address - Street 1:13867 FOOTHILL BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-3008
Practice Address - Country:US
Practice Address - Phone:818-364-2323
Practice Address - Fax:818-364-5460
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC14136111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA344447700OtherDOL PROVIDER #
CA344447700OtherDOL PROVIDER #
CAT17704Medicare UPIN