Healthcare Provider Details

I. General information

NPI: 1407952146
Provider Name (Legal Business Name): STEPHEN DAHLIN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 05/20/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35234 HIGHWAY 41
COARSEGOLD CA
93614
US

IV. Provider business mailing address

PO BOX 970
COARSEGOLD CA
93614
US

V. Phone/Fax

Practice location:
  • Phone: 559-683-6292
  • Fax: 866-211-8355
Mailing address:
  • Phone: 559-683-6292
  • Fax: 559-683-4742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC24325
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: