Provider Demographics
NPI:1891934022
Name:VALLEY CHIROPRACTIC
Entity Type:Organization
Organization Name:VALLEY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FROZENFAR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:650-941-4475
Mailing Address - Street 1:811 ALTOS OAKS DR
Mailing Address - Street 2:SUITE #3
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94024-5426
Mailing Address - Country:US
Mailing Address - Phone:650-941-4475
Mailing Address - Fax:650-941-4446
Practice Address - Street 1:811 ALTOS OAKS DR
Practice Address - Street 2:SUITE #3
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94024-5426
Practice Address - Country:US
Practice Address - Phone:650-941-4475
Practice Address - Fax:650-941-4446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-11
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 24679111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0246790Medicare PIN