Provider Demographics
NPI:1326100124
Name:TAO FAMILY CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:TAO FAMILY CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHINORI
Authorized Official - Middle Name:
Authorized Official - Last Name:TAO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:805-384-2363
Mailing Address - Street 1:484 MOBIL AVE
Mailing Address - Street 2:SUITE 27
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-6303
Mailing Address - Country:US
Mailing Address - Phone:805-384-2363
Mailing Address - Fax:805-384-2364
Practice Address - Street 1:484 MOBIL AVE
Practice Address - Street 2:SUITE 27
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-6303
Practice Address - Country:US
Practice Address - Phone:805-384-2363
Practice Address - Fax:805-384-2364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17905111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6462550001Medicare NSC
DC17905Medicare ID - Type Unspecified
CAT06585Medicare UPIN