Provider Demographics
NPI:1790021103
Name:ROBERT D. MORGAN, D.C., INC.
Entity Type:Organization
Organization Name:ROBERT D. MORGAN, D.C., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:530-274-7007
Mailing Address - Street 1:565 BRUNSWICK RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-9529
Mailing Address - Country:US
Mailing Address - Phone:530-274-7007
Mailing Address - Fax:530-274-3476
Practice Address - Street 1:565 BRUNSWICK RD
Practice Address - Street 2:SUITE 5
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-9529
Practice Address - Country:US
Practice Address - Phone:530-274-7007
Practice Address - Fax:530-274-3476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-13
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17530111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0175300Medicare UPIN
CA1033120829Medicare PIN