Healthcare Provider Details

I. General information

NPI: 1194602078
Provider Name (Legal Business Name): AXELROD PERFORMANCE CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2025
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4962 EL CAMINO REAL STE 120
LOS ALTOS CA
94022-1410
US

IV. Provider business mailing address

180 WAVERLY ST
SUNNYVALE CA
94086-6021
US

V. Phone/Fax

Practice location:
  • Phone: 408-502-7427
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: DANIEL AXELROD
Title or Position: OWNER/CHIROPRACTOR/ACUPUNCTURIST
Credential: D.C., L.AC
Phone: 516-233-9003