Healthcare Provider Details

I. General information

NPI: 1699547406
Provider Name (Legal Business Name): DANIEL ROBERT FLYNN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2023
Last Update Date: 10/25/2023
Certification Date: 08/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 SUNRISE BLVD
CITRUS HEIGHTS CA
95610-5998
US

IV. Provider business mailing address

6400 SUNRISE BLVD STE A
CITRUS HEIGHTS CA
95610-5998
US

V. Phone/Fax

Practice location:
  • Phone: 916-727-6400
  • Fax:
Mailing address:
  • Phone: 916-727-6400
  • Fax: 916-727-3292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC-011904
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: