Provider Demographics
NPI:1629131073
Name:ORENDAIN, ERNESTO S (DC)
Entity Type:Individual
Prefix:
First Name:ERNESTO
Middle Name:S
Last Name:ORENDAIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:ERNESTO
Other - Middle Name:
Other - Last Name:SERRATOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3901 NORWOOD AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95838
Mailing Address - Country:US
Mailing Address - Phone:916-646-5526
Mailing Address - Fax:916-646-0701
Practice Address - Street 1:3901 NORWOOD AVE
Practice Address - Street 2:SUITE A
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95838
Practice Address - Country:US
Practice Address - Phone:916-646-5526
Practice Address - Fax:916-646-0701
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19981111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0199810Medicare ID - Type Unspecified