Provider Demographics
NPI:1356472385
Name:DUBYAK CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:DUBYAK CHIROPRACTIC, INC.
Other - Org Name:DUBYAK FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:DUBYAK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:209-668-1944
Mailing Address - Street 1:2445 GREENBORO ST
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-1433
Mailing Address - Country:US
Mailing Address - Phone:209-634-6223
Mailing Address - Fax:
Practice Address - Street 1:3008 GEER RD
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-1117
Practice Address - Country:US
Practice Address - Phone:209-668-1944
Practice Address - Fax:209-668-4226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19104111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ06697ZOtherBLUESHIELD PIN
CADG7419OtherRAILROAD MEDICARE PTAN
CAZZZ06277ZOtherMEDICARE PTAN