Provider Demographics
NPI:1467848820
Name:ACRU HEALTH
Entity Type:Organization
Organization Name:ACRU HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMON
Authorized Official - Suffix:IV
Authorized Official - Credentials:DC
Authorized Official - Phone:619-295-2278
Mailing Address - Street 1:2970 5TH AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-5929
Mailing Address - Country:US
Mailing Address - Phone:619-295-2278
Mailing Address - Fax:
Practice Address - Street 1:2970 5TH AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-5929
Practice Address - Country:US
Practice Address - Phone:619-295-2278
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-13
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33050111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1891197901Medicare NSC
CA1548662653Medicare NSC