Provider Demographics
NPI:1518044130
Name:HAYES CHIROPRACTIC INC
Entity Type:Organization
Organization Name:HAYES CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:209-368-6639
Mailing Address - Street 1:PO BOX 707
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95241-0707
Mailing Address - Country:US
Mailing Address - Phone:209-368-6639
Mailing Address - Fax:209-368-7330
Practice Address - Street 1:820 S FAIRMONT AVE
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95240-5117
Practice Address - Country:US
Practice Address - Phone:209-368-6639
Practice Address - Fax:209-368-7330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ16708ZMedicare ID - Type Unspecified750 SPAANS DRIVE GALT
CAZZZ15115ZMedicare ID - Type Unspecified2707 E FREMONT SUITE 6
CAZZZ78172ZMedicare ID - Type Unspecified820 S FAIRMONT
CAZZZ26410ZMedicare ID - Type Unspecified9008 THORNTON ROAD