Healthcare Provider Details

I. General information

NPI: 1346464690
Provider Name (Legal Business Name): MICHAEL J SLONE DC, DACNB
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 12/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4588 PERALTA BLVD STE 7
FREMONT CA
94536-5757
US

IV. Provider business mailing address

4588 PERALTA BLVD STE 7
FREMONT CA
94536-5757
US

V. Phone/Fax

Practice location:
  • Phone: 510-793-4835
  • Fax: 510-793-6399
Mailing address:
  • Phone: 510-793-4835
  • Fax: 510-793-6399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License NumberDC22169
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-12-12648
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: