Provider Demographics
NPI:1346531746
Name:CRUZ-SILVESTRE, ABNER (DC)
Entity Type:Individual
Prefix:DR
First Name:ABNER
Middle Name:
Last Name:CRUZ-SILVESTRE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:ABNER
Other - Middle Name:SILVESTRE
Other - Last Name:CRUZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:2930 CORONADO AVE STE B
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92154-2188
Mailing Address - Country:US
Mailing Address - Phone:619-423-8414
Mailing Address - Fax:
Practice Address - Street 1:2930 CORONADO AVE STE B
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92154-2188
Practice Address - Country:US
Practice Address - Phone:619-423-8414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31965111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor