Provider Demographics
NPI:1285824003
Name:LOW, COLLEN WILLIAM (DC)
Entity Type:Individual
Prefix:
First Name:COLLEN
Middle Name:WILLIAM
Last Name:LOW
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 1:3450 GEARY BLVD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-3379
Mailing Address - Country:US
Mailing Address - Phone:415-221-9228
Mailing Address - Fax:
Practice Address - Street 1:3450 GEARY BLVD
Practice Address - Street 2:SUITE 112
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-3379
Practice Address - Country:US
Practice Address - Phone:415-221-9228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC021040111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4152219228Medicare PIN