Provider Demographics
NPI:1477875854
Name:COMPASS CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:COMPASS CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNARDINO
Authorized Official - Middle Name:B
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-730-0220
Mailing Address - Street 1:7950 DUBLIN BLVD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-2929
Mailing Address - Country:US
Mailing Address - Phone:925-730-0220
Mailing Address - Fax:
Practice Address - Street 1:7950 DUBLIN BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-2929
Practice Address - Country:US
Practice Address - Phone:925-730-0220
Practice Address - Fax:925-463-0646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-25
Last Update Date:2015-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 31191111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGN088ZOtherMEDICARE PTAN