Provider Demographics
NPI:1265657829
Name:CHIROPRACTIC CARE
Entity Type:Organization
Organization Name:CHIROPRACTIC CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:408-937-8988
Mailing Address - Street 1:244 N JACKSON AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1604
Mailing Address - Country:US
Mailing Address - Phone:408-937-8988
Mailing Address - Fax:408-937-8222
Practice Address - Street 1:244 N JACKSON AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1604
Practice Address - Country:US
Practice Address - Phone:408-937-8988
Practice Address - Fax:408-937-8222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty