Provider Demographics
NPI:1639487838
Name:FARR CHIROPRACTIC OF CAMERON PARK PC
Entity Type:Organization
Organization Name:FARR CHIROPRACTIC OF CAMERON PARK PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LORIN
Authorized Official - Middle Name:GUEST
Authorized Official - Last Name:FARR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:530-677-4468
Mailing Address - Street 1:3091 ALHAMBRA DR STE A
Mailing Address - Street 2:
Mailing Address - City:CAMERON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:95682-7635
Mailing Address - Country:US
Mailing Address - Phone:530-677-4468
Mailing Address - Fax:530-677-1665
Practice Address - Street 1:3091 ALHAMBRA DR STE A
Practice Address - Street 2:
Practice Address - City:CAMERON PARK
Practice Address - State:CA
Practice Address - Zip Code:95682-7635
Practice Address - Country:US
Practice Address - Phone:530-677-4468
Practice Address - Fax:530-677-1665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-22
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12401111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
T04746Medicare UPIN