Provider Demographics
NPI:1982750725
Name:SORENSEN, TROY DOUGLAS (DC)
Entity type:Individual
Prefix:MR
First Name:TROY
Middle Name:DOUGLAS
Last Name:SORENSEN
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 1:8501 CAMINO MEDIA
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311
Mailing Address - Country:US
Mailing Address - Phone:661-665-1800
Mailing Address - Fax:661-665-8858
Practice Address - Street 1:8501 CAMINO MEDIA
Practice Address - Street 2:SUITE 200
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-1354
Practice Address - Country:US
Practice Address - Phone:661-665-1800
Practice Address - Fax:661-665-8858
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24224111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC024224Medicare ID - Type Unspecified