Provider Demographics
NPI:1730312307
Name:RHODES-JACOBS CHIROPRACTIC CORP
Entity Type:Organization
Organization Name:RHODES-JACOBS CHIROPRACTIC CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/DC
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDOLPH
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:RHODES
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:650-400-1913
Mailing Address - Street 1:871 INDUSTRIAL RD STE B
Mailing Address - Street 2:
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-3389
Mailing Address - Country:US
Mailing Address - Phone:650-654-4595
Mailing Address - Fax:650-654-4573
Practice Address - Street 1:650 EL CAMINO REAL STE S
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1345
Practice Address - Country:US
Practice Address - Phone:650-654-4595
Practice Address - Fax:650-654-4573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-31
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC16496111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty