Provider Demographics
NPI:1497870455
Name:ZORICH, THOMAS (CD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:ZORICH
Suffix:
Gender:M
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 SANTA CLARA DR
Mailing Address - Street 2:110
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-4420
Mailing Address - Country:US
Mailing Address - Phone:916-784-9584
Mailing Address - Fax:916-784-1440
Practice Address - Street 1:1624 SANTA CLARA DR.
Practice Address - Street 2:SUITE #110
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-4420
Practice Address - Country:US
Practice Address - Phone:916-784-9584
Practice Address - Fax:916-784-1440
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20052111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1063503043OtherNPI
CA06-0697610OtherTIN
CA06-0697610OtherTIN