Provider Demographics
NPI:1831421502
Name:KRYNEN, PAUL J (DC)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:J
Last Name:KRYNEN
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 1:123 E F ST
Mailing Address - Street 2:SUITE H
Mailing Address - City:WILMINGTON
Mailing Address - State:CA
Mailing Address - Zip Code:90744-5817
Mailing Address - Country:US
Mailing Address - Phone:310-549-4999
Mailing Address - Fax:310-549-6942
Practice Address - Street 1:123 E F ST
Practice Address - Street 2:SUITE H
Practice Address - City:WILMINGTON
Practice Address - State:CA
Practice Address - Zip Code:90744-5817
Practice Address - Country:US
Practice Address - Phone:310-549-4999
Practice Address - Fax:310-549-6942
Is Sole Proprietor?:No
Enumeration Date:2010-02-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14851111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor