Provider Demographics
NPI:1417440959
Name:PERKINS-MAZOR CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:PERKINS-MAZOR CHIROPRACTIC, INC.
Other - Org Name:SOJOURN WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAZOR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:510-238-8500
Mailing Address - Street 1:3201 MACARTHUR BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-3819
Mailing Address - Country:US
Mailing Address - Phone:510-238-8505
Mailing Address - Fax:
Practice Address - Street 1:3201 MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-3819
Practice Address - Country:US
Practice Address - Phone:510-238-8505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-09
Last Update Date:2018-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33170261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center