Provider Demographics
NPI:1184815482
Name:SCHICK CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:SCHICK CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:MORRIS
Authorized Official - Last Name:SCHICK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:925-274-1000
Mailing Address - Street 1:140 MAYHEW
Mailing Address - Street 2:SUITE 900
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523
Mailing Address - Country:US
Mailing Address - Phone:925-274-1000
Mailing Address - Fax:925-274-1002
Practice Address - Street 1:140 MAYHEW WAY
Practice Address - Street 2:SUITE 900
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523
Practice Address - Country:US
Practice Address - Phone:925-274-1000
Practice Address - Fax:925-274-1002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 21120111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC 21120OtherLICENCE
U18841Medicare UPIN
DC0211200Medicare PIN