Provider Demographics
NPI:1841409687
Name:CULVER CHIROPRACTIC PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:CULVER CHIROPRACTIC PROFESSIONAL CORPORATION
Other - Org Name:BAY AREA SPINE SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:CULVER
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DACNB
Authorized Official - Phone:650-559-7500
Mailing Address - Street 1:480 SAN ANTONIO RD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-1251
Mailing Address - Country:US
Mailing Address - Phone:650-559-7500
Mailing Address - Fax:650-559-7501
Practice Address - Street 1:480 SAN ANTONIO RD
Practice Address - Street 2:SUITE 115
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-1251
Practice Address - Country:US
Practice Address - Phone:650-559-7500
Practice Address - Fax:650-559-7501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC8941111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1578632352OtherNPI
CADC0089410Medicare ID - Type UnspecifiedMEDICARE NUMBER