Provider Demographics
NPI:1083026827
Name:CHIROPRACTIC SPORTS CARE, INC.
Entity Type:Organization
Organization Name:CHIROPRACTIC SPORTS CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:VALENCIA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:415-867-2781
Mailing Address - Street 1:150 HAIGHT ST
Mailing Address - Street 2:606
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-5749
Mailing Address - Country:US
Mailing Address - Phone:415-867-2781
Mailing Address - Fax:415-875-9688
Practice Address - Street 1:1874 MARKET ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-6227
Practice Address - Country:US
Practice Address - Phone:415-867-2781
Practice Address - Fax:415-875-9688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-28
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23604111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1669797692OtherNPI (INDIVIDUAL) NUMBER