Provider Demographics
NPI:1023389574
Name:JAMIE R STERN CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:JAMIE R STERN CHIROPRACTIC CORPORATION
Other - Org Name:MEAKIM & STERN FAMILY SPINAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:415-308-7636
Mailing Address - Street 1:224 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-2303
Mailing Address - Country:US
Mailing Address - Phone:415-308-7636
Mailing Address - Fax:408-523-1232
Practice Address - Street 1:130 S FRANCES ST
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94086-6132
Practice Address - Country:US
Practice Address - Phone:415-308-7636
Practice Address - Fax:408-523-1232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-14
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29006111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACZ706ZMedicare PIN