Provider Demographics
NPI:1700809340
Name:DANCHIK, STEVEN P (PT)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:P
Last Name:DANCHIK
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 940369
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93094-0369
Mailing Address - Country:US
Mailing Address - Phone:818-909-7038
Mailing Address - Fax:818-909-7039
Practice Address - Street 1:15333 SHERMAN WAY
Practice Address - Street 2:SUITE P
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-4206
Practice Address - Country:US
Practice Address - Phone:818-909-7038
Practice Address - Fax:818-909-7939
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2010-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT5208225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT5208OtherPT LICENSE
CA95-3092170OtherEIN
CAW18801Medicare ID - Type Unspecified
CAPT5208OtherPT LICENSE