Provider Demographics
NPI:1700461761
Name:PARKER, DANIEL G III (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:G
Last Name:PARKER
Suffix:III
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 1:25431 CABOT RD STE 118
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-5527
Mailing Address - Country:US
Mailing Address - Phone:949-362-8877
Mailing Address - Fax:949-362-9230
Practice Address - Street 1:25431 CABOT RD STE 118
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-5527
Practice Address - Country:US
Practice Address - Phone:949-362-8877
Practice Address - Fax:949-362-9230
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-11
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36041111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor