Provider Demographics
NPI:1417070434
Name:BARSTEN, GREG (DC)
Entity Type:Individual
Prefix:DR
First Name:GREG
Middle Name:
Last Name:BARSTEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14107 WINCHESTER BLVD
Mailing Address - Street 2:SUITE J
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-1836
Mailing Address - Country:US
Mailing Address - Phone:408-358-2225
Mailing Address - Fax:408-540-7108
Practice Address - Street 1:14107 WINCHESTER BLVD
Practice Address - Street 2:SUITE J
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1836
Practice Address - Country:US
Practice Address - Phone:408-358-2225
Practice Address - Fax:408-540-7108
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CADC18320111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU23583Medicare UPIN