Healthcare Provider Details

I. General information

NPI: 1912845363
Provider Name (Legal Business Name): BDX MEDICARE CHIROPRACTIC DANIELS AND STANISLAWSKI PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 RANCHO CONEJO BLVD
THOUSAND OAKS CA
91320-1718
US

IV. Provider business mailing address

1011 RANCHO CONEJO BLVD
THOUSAND OAKS CA
91320-1718
US

V. Phone/Fax

Practice location:
  • Phone: 844-472-1476
  • Fax: 805-273-4084
Mailing address:
  • Phone: 844-472-1476
  • Fax: 805-273-4084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: RICHARD BEAU DANIELS
Title or Position: SECRETARY
Credential: DC
Phone: 844-472-1476