Provider Demographics
NPI:1639569981
Name:DR SAL SPORTS AND REHAB
Entity Type:Organization
Organization Name:DR SAL SPORTS AND REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COOWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:SALVADORE
Authorized Official - Middle Name:
Authorized Official - Last Name:KERKAR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:562-301-2742
Mailing Address - Street 1:1000 E DOMINGUEZ ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-3600
Mailing Address - Country:US
Mailing Address - Phone:310-327-1325
Mailing Address - Fax:310-327-7058
Practice Address - Street 1:1000 E DOMINGUEZ ST
Practice Address - Street 2:SUITE 101
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90746-3600
Practice Address - Country:US
Practice Address - Phone:310-327-1325
Practice Address - Fax:310-327-7058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30838111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty