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General NPI Number Information
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NPI Number | 1871881243
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Entity Type | Individual
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Provider Name | JGOR G DANILOV DC
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Gender | Male
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Dates
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Enumeration Date | 07/19/2011
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Last Update Date | 07/19/2011
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Provider Practice Location Address
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Address Line | 5531 HEMLOCK ST
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City | SACRAMENTO
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State | CA
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Zip | 95841-2709
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Country | US
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Telephone | 916-978-9211
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Fax | 916-978-9529
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Provider Business Mailing Address
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Address Line | 2322 BUTANO DR STE# 209
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City | SACRAMENTO
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State | CA
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Zip | 95825-0629
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Country | US
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Telephone | 916-978-9211
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Fax | 916-978-9529
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 24110
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License Number State | CA
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