Provider Demographics
NPI:1124393780
Name:DC ATKINSON DC INC
Entity Type:Organization
Organization Name:DC ATKINSON DC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:MINETTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-287-9300
Mailing Address - Street 1:670 GREGORY LN STE C
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-2771
Mailing Address - Country:US
Mailing Address - Phone:925-289-7300
Mailing Address - Fax:925-746-7780
Practice Address - Street 1:670 GREGORY LN STE C
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-2771
Practice Address - Country:US
Practice Address - Phone:925-289-7300
Practice Address - Fax:925-746-7780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-15
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13275111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT04948Medicare UPIN