Provider Demographics
NPI:1891906079
Name:BACHMAN, TRENT RAY (D,C,)
Entity Type:Individual
Prefix:DR
First Name:TRENT
Middle Name:RAY
Last Name:BACHMAN
Suffix:
Gender:M
Credentials:D,C,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:795 GAMAY CT
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-6825
Mailing Address - Country:US
Mailing Address - Phone:925-462-0893
Mailing Address - Fax:925-462-1239
Practice Address - Street 1:795 GAMAY CT
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-6825
Practice Address - Country:US
Practice Address - Phone:925-462-0893
Practice Address - Fax:925-462-1239
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO15481111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC15481Medicare ID - Type Unspecified