Provider Demographics
NPI:1316916547
Name:STADLER, ANN C (DC)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:C
Last Name:STADLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 DAKOTA AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-6626
Mailing Address - Country:US
Mailing Address - Phone:831-459-9985
Mailing Address - Fax:831-459-0543
Practice Address - Street 1:111 DAKOTA AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-6626
Practice Address - Country:US
Practice Address - Phone:831-459-9985
Practice Address - Fax:831-459-0543
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20408111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0204080Medicare ID - Type Unspecified