Provider Demographics
NPI:1164712980
Name:FARIA CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:FARIA CHIROPRACTIC, INC.
Other - Org Name:MARINA WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:FARIA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:510-835-7000
Mailing Address - Street 1:428 ALICE ST # 110
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-4326
Mailing Address - Country:US
Mailing Address - Phone:510-835-7000
Mailing Address - Fax:
Practice Address - Street 1:428 ALICE ST # 110
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-4326
Practice Address - Country:US
Practice Address - Phone:510-835-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31750273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit