Provider Demographics
NPI:1538188180
Name:MASSARI, DANIEL M (DC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:M
Last Name:MASSARI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42544 10TH ST W STE G
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-7079
Mailing Address - Country:US
Mailing Address - Phone:166-949-6649
Mailing Address - Fax:661-949-9431
Practice Address - Street 1:42544 10TH ST W STE G
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-7079
Practice Address - Country:US
Practice Address - Phone:166-949-6649
Practice Address - Fax:661-949-9431
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2025-03-14
Deactivation Date:2025-03-11
Deactivation Code:
Reactivation Date:2025-03-14
Provider Licenses
StateLicense IDTaxonomies
CADC 17751111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC17751Medicare PIN