Provider Demographics
NPI:1932275955
Name:SITZMANN, PATRICK MEYLOR
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:MEYLOR
Last Name:SITZMANN
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:PATRICK
Other - Middle Name:MEYLOR
Other - Last Name:SITZMANN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:25 EVERGREEN AVE
Mailing Address - Street 2:SUITE #7
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-3356
Mailing Address - Country:US
Mailing Address - Phone:415-381-2700
Mailing Address - Fax:415-381-2700
Practice Address - Street 1:25 EVERGREEN AVE
Practice Address - Street 2:SUITE #7
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-3356
Practice Address - Country:US
Practice Address - Phone:415-381-2700
Practice Address - Fax:415-381-2700
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12539111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC012539Medicare ID - Type Unspecified