Provider Demographics
NPI:1336288109
Name:PAYNE CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:PAYNE CHIROPRACTIC, INC.
Other - Org Name:RIVER OAKS CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:C
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:408-435-1133
Mailing Address - Street 1:670 RIVER OAKS PKWY STE K
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95134-1988
Mailing Address - Country:US
Mailing Address - Phone:408-435-1133
Mailing Address - Fax:408-435-1166
Practice Address - Street 1:670 RIVER OAKS PKWY STE K
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95134-1988
Practice Address - Country:US
Practice Address - Phone:408-435-1133
Practice Address - Fax:408-435-1166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21466111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty