Provider Demographics
NPI:1740405521
Name:SUNOFSKY, CAROL J (DC)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:J
Last Name:SUNOFSKY
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 1:8334 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-3823
Mailing Address - Country:US
Mailing Address - Phone:619-463-1700
Mailing Address - Fax:619-463-1920
Practice Address - Street 1:8334 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-3823
Practice Address - Country:US
Practice Address - Phone:619-463-1700
Practice Address - Fax:619-463-1920
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19623111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0196230OtherBLUE SHIELD
CADC19623AMedicare ID - Type Unspecified