Provider Demographics
NPI:1184846180
Name:SALABARRIA, FREDDIE (DC)
Entity Type:Individual
Prefix:DR
First Name:FREDDIE
Middle Name:
Last Name:SALABARRIA
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 1:9535 MISSION GORGE ROAD
Mailing Address - Street 2:SUITE G
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071
Mailing Address - Country:US
Mailing Address - Phone:619-562-3330
Mailing Address - Fax:619-631-7330
Practice Address - Street 1:9535 MISSION GORGE ROAD
Practice Address - Street 2:SUITE G
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071
Practice Address - Country:US
Practice Address - Phone:619-562-3330
Practice Address - Fax:619-631-7330
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 25501111N00000X, 111NN1001X, 111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered111NN1001XChiropractic ProvidersChiropractorNutrition
Not Answered111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC25501OtherCHIROPRACTOR