Provider Demographics
NPI:1780669788
Name:COBURN, RACHEL ELLEN (DC)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:ELLEN
Last Name:COBURN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6520 VON DOLLEN RD
Mailing Address - Street 2:
Mailing Address - City:SAN MIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:93451-9567
Mailing Address - Country:US
Mailing Address - Phone:805-467-2203
Mailing Address - Fax:
Practice Address - Street 1:1106 VINE ST
Practice Address - Street 2:
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-2576
Practice Address - Country:US
Practice Address - Phone:805-237-7380
Practice Address - Fax:805-237-1302
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29925111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor