Provider Demographics
NPI:1144618596
Name:L.C. STUBBLEFIELD FAMILY CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:L.C. STUBBLEFIELD FAMILY CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDEN-TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:C
Authorized Official - Last Name:STUBBLEFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:530-674-2803
Mailing Address - Street 1:870 W ONSTOTT FRONTAGE RD STE G
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-3500
Mailing Address - Country:US
Mailing Address - Phone:530-674-2803
Mailing Address - Fax:530-674-2859
Practice Address - Street 1:870 W ONSTOTT FRONTAGE RD STE G
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-3500
Practice Address - Country:US
Practice Address - Phone:530-674-2803
Practice Address - Fax:530-674-2859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-07
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA016547261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT06181Medicare UPIN