Provider Demographics
NPI:1568501807
Name:VITKOFF CHIROPRACTIC INC
Entity Type:Organization
Organization Name:VITKOFF CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VITKOFF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:415-781-1131
Mailing Address - Street 1:396 TOWNSEND ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-1607
Mailing Address - Country:US
Mailing Address - Phone:415-781-1131
Mailing Address - Fax:415-781-2108
Practice Address - Street 1:396 TOWNSEND ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-1607
Practice Address - Country:US
Practice Address - Phone:415-781-1131
Practice Address - Fax:415-781-2108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC13703111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1467467134OtherNPI ENUMERATOR TYPE 1
CADC0137030Medicare ID - Type UnspecifiedMEDICARE NUMBER