Provider Demographics
NPI:1922212232
Name:PRESNICK CHIROPRACTIC OFFICE
Entity Type:Organization
Organization Name:PRESNICK CHIROPRACTIC OFFICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:D
Authorized Official - Last Name:PRESNICK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:925-609-9355
Mailing Address - Street 1:395 CIVIC DR STE E
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-1949
Mailing Address - Country:US
Mailing Address - Phone:925-609-9355
Mailing Address - Fax:
Practice Address - Street 1:395 CIVIC DR STE E
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-1949
Practice Address - Country:US
Practice Address - Phone:925-609-9355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13370111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC133690Medicare ID - Type UnspecifiedDR. BRUCE PRESNICK
CADC133700Medicare ID - Type UnspecifiedDR. LAURA PRESNICK
CAT04995Medicare UPIN
CAT04994Medicare UPIN