Provider Demographics
NPI:1245401900
Name:SAM LI CHIROPRACTIC INC
Entity Type:Organization
Organization Name:SAM LI CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:S
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:415-682-0706
Mailing Address - Street 1:2451 JUDAH STREET
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122
Mailing Address - Country:US
Mailing Address - Phone:415-682-0706
Mailing Address - Fax:415-707-6800
Practice Address - Street 1:2451 JUDAH STREET
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122
Practice Address - Country:US
Practice Address - Phone:415-682-0706
Practice Address - Fax:415-707-6800
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAM LI CHIROPRACTIC INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-20
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26429111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty