Provider Demographics
NPI:1972042737
Name:MICHAEL BIEGANSKI DC A PROFESSIONAL CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:MICHAEL BIEGANSKI DC A PROFESSIONAL CHIROPRACTIC CORPORATION
Other - Org Name:DYNAMIC CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BIEGANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:408-206-5909
Mailing Address - Street 1:6146 CAMINO VERDE DR
Mailing Address - Street 2:SUITE P
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95119-1460
Mailing Address - Country:US
Mailing Address - Phone:408-206-5909
Mailing Address - Fax:408-224-5409
Practice Address - Street 1:6146 CAMINO VERDE DR
Practice Address - Street 2:SUITE P
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95119
Practice Address - Country:US
Practice Address - Phone:408-206-5909
Practice Address - Fax:408-224-5409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-13
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29834111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty