Provider Demographics
NPI:1104853571
Name:RAZZ, ERICK (DC)
Entity Type:Individual
Prefix:
First Name:ERICK
Middle Name:
Last Name:RAZZ
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 1:286 E HAMILTON AVE STE K
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-0242
Mailing Address - Country:US
Mailing Address - Phone:408-379-6100
Mailing Address - Fax:408-379-6175
Practice Address - Street 1:286 E HAMILTON AVE STE K
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-0242
Practice Address - Country:US
Practice Address - Phone:408-379-6100
Practice Address - Fax:408-379-6175
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16146111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0161460Medicare ID - Type Unspecified