Provider Demographics
NPI:1356813851
Name:NORTH VALLEY CHIROPRACTIC CTR, INC
Entity Type:Organization
Organization Name:NORTH VALLEY CHIROPRACTIC CTR, INC
Other - Org Name:DR. TIFFANY THUAN-HAU HO,DC
Other - Org Type:Other Name
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:THUAN-HAU
Authorized Official - Last Name:HO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:408-262-5130
Mailing Address - Street 1:2684 CROPLEY AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95132-3711
Mailing Address - Country:US
Mailing Address - Phone:408-262-5130
Mailing Address - Fax:
Practice Address - Street 1:2684 CROPLEY AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95132-3711
Practice Address - Country:US
Practice Address - Phone:408-262-5130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-20
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0272410Medicaid
CADC0272410OtherMEDICARE
CADC27241OtherLICENSED DOCTOR OF CHIROPRACTIC
CA1699985978OtherTYPE 1 NPI