Provider Demographics
NPI:1669682803
Name:ADAMICH, ROBERT J (DC, BA)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:ADAMICH
Suffix:
Gender:M
Credentials:DC, BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1115 IRWIN ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-3321
Mailing Address - Country:US
Mailing Address - Phone:415-272-4744
Mailing Address - Fax:415-457-9119
Practice Address - Street 1:1115 IRWIN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-3321
Practice Address - Country:US
Practice Address - Phone:415-272-4744
Practice Address - Fax:415-457-9119
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29247111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor