Healthcare Provider Details

I. General information

NPI: 1003944315
Provider Name (Legal Business Name): STEVEN D FUNK D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 03/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 EAST AVE
LINCOLN CA
95648-2007
US

IV. Provider business mailing address

15550 ROCKFIELD BLVD B220
IRVINE CA
92618-2720
US

V. Phone/Fax

Practice location:
  • Phone: 916-645-3890
  • Fax: 916-645-1692
Mailing address:
  • Phone: 949-598-9999
  • Fax: 949-598-9990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberDC25869
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: