Provider Demographics
NPI:1417172198
Name:SERPA CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:SERPA CHIROPRACTIC INC.
Other - Org Name:ADVNCED CHIROPRACTIC OF FOLSOM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:SERPA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:916-984-1939
Mailing Address - Street 1:324 S LEXINGTON DR
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-6801
Mailing Address - Country:US
Mailing Address - Phone:916-984-1939
Mailing Address - Fax:
Practice Address - Street 1:324 S LEXINGTON DR
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-6801
Practice Address - Country:US
Practice Address - Phone:916-984-1939
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACOR2378111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACOR 2378OtherCHIRO. CORPORATION NUMBER