Provider Demographics
NPI:1760718019
Name:COMPLETE CHIROPRACTIC HEALTHCARE
Entity Type:Organization
Organization Name:COMPLETE CHIROPRACTIC HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:DC, CSCS
Authorized Official - Phone:925-321-4668
Mailing Address - Street 1:PO BOX 5100
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-0600
Mailing Address - Country:US
Mailing Address - Phone:925-321-4668
Mailing Address - Fax:925-886-4897
Practice Address - Street 1:4165 BLACKHAWK PLAZA CIR
Practice Address - Street 2:SUITE 250
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94506-4904
Practice Address - Country:US
Practice Address - Phone:925-321-4668
Practice Address - Fax:925-886-4897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-21
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29442111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0294420Medicare PIN