Provider Demographics
NPI:1538107065
Name:BELUSA, ERIC ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:ROBERT
Last Name:BELUSA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4425 TREAT BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94521-2796
Mailing Address - Country:US
Mailing Address - Phone:925-687-5515
Mailing Address - Fax:925-687-5588
Practice Address - Street 1:4425 TREAT BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94521-2796
Practice Address - Country:US
Practice Address - Phone:925-687-5515
Practice Address - Fax:925-687-5588
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22587111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U48376Medicare UPIN
DC02258710Medicare ID - Type Unspecified