Provider Demographics
NPI:1568539070
Name:YOUNGERMAN & ABUSAIDI CHIROPRACTIC CLINIC, INC.
Entity Type:Organization
Organization Name:YOUNGERMAN & ABUSAIDI CHIROPRACTIC CLINIC, INC.
Other - Org Name:SAN MATEO CHIROPRACTIC CLINIC REDWOOD CITY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:V.P.
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:YOUNGERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:650-345-7010
Mailing Address - Street 1:16 41ST AVE
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-5106
Mailing Address - Country:US
Mailing Address - Phone:650-345-7010
Mailing Address - Fax:650-345-7470
Practice Address - Street 1:16 41ST AVE
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-5106
Practice Address - Country:US
Practice Address - Phone:650-345-7010
Practice Address - Fax:650-345-7470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
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
CAZZZ51491ZOtherBLUE SHIELD
CAZZZ51491ZOtherBLUE SHIELD