Provider Demographics
NPI:1790548816
Name:INTERO CHIROPRACTIC A HSIEH CORPORATION D
Entity Type:Organization
Organization Name:INTERO CHIROPRACTIC A HSIEH CORPORATION D
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:HSIEH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:925-319-6133
Mailing Address - Street 1:6620 OWENS DR
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-3341
Mailing Address - Country:US
Mailing Address - Phone:925-255-5805
Mailing Address - Fax:
Practice Address - Street 1:1710 S AMPHLETT BLVD STE 112
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-2704
Practice Address - Country:US
Practice Address - Phone:650-977-1788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-01
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty