Provider Demographics
NPI:1932221314
Name:GABRIELSON, MICHAEL ARNOLD (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ARNOLD
Last Name:GABRIELSON
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 1:5820 STONERIDGE MALL RD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-3274
Mailing Address - Country:US
Mailing Address - Phone:925-460-3877
Mailing Address - Fax:925-460-8437
Practice Address - Street 1:5820 STONERIDGE MALL RD
Practice Address - Street 2:SUITE 115
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-3274
Practice Address - Country:US
Practice Address - Phone:925-460-3877
Practice Address - Fax:925-460-8437
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16178111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor