Provider Demographics
NPI:1760826051
Name:ATHERTON SORRENTI DC
Entity Type:Organization
Organization Name:ATHERTON SORRENTI DC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ATHERTON
Authorized Official - Middle Name:
Authorized Official - Last Name:SORRENTI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-946-0801
Mailing Address - Street 1:2425 CAMINO DEL RIO S
Mailing Address - Street 2:STE 180
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3744
Mailing Address - Country:US
Mailing Address - Phone:619-295-2225
Mailing Address - Fax:619-260-1798
Practice Address - Street 1:2425 CAMINO DEL RIO S
Practice Address - Street 2:STE 180
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3744
Practice Address - Country:US
Practice Address - Phone:619-295-2225
Practice Address - Fax:619-260-1798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-17
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32499261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center