Provider Demographics
NPI:1538261631
Name:ZUMSTAIN, MICHAEL CARL (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CARL
Last Name:ZUMSTAIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1502 ST MARKS PLAZA
Mailing Address - Street 2:#4
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-6409
Mailing Address - Country:US
Mailing Address - Phone:916-774-2600
Mailing Address - Fax:209-957-6568
Practice Address - Street 1:1502 ST MARKS PLAZA
Practice Address - Street 2:#4
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-6409
Practice Address - Country:US
Practice Address - Phone:916-774-2600
Practice Address - Fax:209-957-6568
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CADC18706111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor