Provider Demographics
NPI:1700221926
Name:SORENSEN CHIROPRACTIC, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:SORENSEN CHIROPRACTIC, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:F
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:SORENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:530-671-4616
Mailing Address - Street 1:1650 SIERRA AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95993-8986
Mailing Address - Country:US
Mailing Address - Phone:530-671-4616
Mailing Address - Fax:530-671-6062
Practice Address - Street 1:1095 STAFFORD WAY STE C
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-3333
Practice Address - Country:US
Practice Address - Phone:530-671-4616
Practice Address - Fax:530-671-6062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-01
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19599111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0195990OtherMEDICARE