Provider Demographics
NPI:1245261429
Name:SCLAMBERG, ELLIOT AARON (DC)
Entity type:Individual
Prefix:DR
First Name:ELLIOT
Middle Name:AARON
Last Name:SCLAMBERG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 3RD ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-4390
Mailing Address - Country:US
Mailing Address - Phone:510-446-2225
Mailing Address - Fax:
Practice Address - Street 1:299 3RD ST
Practice Address - Street 2:SUITE 100
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-4390
Practice Address - Country:US
Practice Address - Phone:510-446-2225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2016-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13677111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0136770Medicare ID - Type Unspecified