Provider Demographics
NPI:1013114883
Name:CASHA-CROSS CHIROPRACTIC, INC
Entity Type:Organization
Organization Name:CASHA-CROSS CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:S
Authorized Official - Last Name:CASHA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:916-967-7436
Mailing Address - Street 1:5330 PRIMROSE DR
Mailing Address - Street 2:SUITE 140
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-3520
Mailing Address - Country:US
Mailing Address - Phone:916-967-7436
Mailing Address - Fax:916-967-7456
Practice Address - Street 1:5330 PRIMROSE DR
Practice Address - Street 2:SUITE 140
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-3520
Practice Address - Country:US
Practice Address - Phone:916-967-7436
Practice Address - Fax:916-967-7456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT05522Medicare UPIN