Provider Demographics
NPI:1275071920
Name:VAHL CHIROPRACTIC, INC
Entity Type:Organization
Organization Name:VAHL CHIROPRACTIC, INC
Other - Org Name:VAHL CHIROPRACTIC WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:VAHL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:760-479-0146
Mailing Address - Street 1:2767 WORDEN ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110
Mailing Address - Country:US
Mailing Address - Phone:619-647-4732
Mailing Address - Fax:
Practice Address - Street 1:171 SAXONY RD STE 107
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-6776
Practice Address - Country:US
Practice Address - Phone:760-479-0146
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-02
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30438111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAP026ZMedicare PIN