Provider Demographics
NPI:1144387424
Name:ZIMMERLI, LAUREN DANIELLA (DC)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:DANIELLA
Last Name:ZIMMERLI
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 1:230 N MARYLAND AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-4261
Mailing Address - Country:US
Mailing Address - Phone:818-241-1066
Mailing Address - Fax:818-241-1096
Practice Address - Street 1:230 N MARYLAND AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4261
Practice Address - Country:US
Practice Address - Phone:818-241-1066
Practice Address - Fax:818-241-1096
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC13722111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC13722Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER