Provider Demographics
NPI:1417315441
Name:SEAN SALAZAR
Entity Type:Organization
Organization Name:SEAN SALAZAR
Other - Org Name:SALAZAR CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:SALAZAR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-391-0068
Mailing Address - Street 1:20990 VALLEY GREEN DR APT 704
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-1846
Mailing Address - Country:US
Mailing Address - Phone:970-391-0068
Mailing Address - Fax:
Practice Address - Street 1:14375 SARATOGA AVE STE 101
Practice Address - Street 2:
Practice Address - City:SARATOGA
Practice Address - State:CA
Practice Address - Zip Code:95070-5978
Practice Address - Country:US
Practice Address - Phone:408-634-2096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-04
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33459111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty