Provider Demographics
NPI:1376723544
Name:THONGVICHIT CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:THONGVICHIT CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YUPIN
Authorized Official - Middle Name:
Authorized Official - Last Name:THONGVICHIT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:415-587-1500
Mailing Address - Street 1:4736 MISSION ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-2757
Mailing Address - Country:US
Mailing Address - Phone:415-587-1500
Mailing Address - Fax:
Practice Address - Street 1:4736 MISSION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94112-2757
Practice Address - Country:US
Practice Address - Phone:415-587-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-05
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC16156111N00000X
CADC15050111N00000X
CADC29822111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty