Provider Demographics
NPI:1669531083
Name:TOTAL FITNESS CHIROPRACTIC
Entity type:Organization
Organization Name:TOTAL FITNESS CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAFEI
Authorized Official - Suffix:
Authorized Official - Credentials:DC, RN
Authorized Official - Phone:510-791-6332
Mailing Address - Street 1:39140 PASEO PADRE PKWY
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1612
Mailing Address - Country:US
Mailing Address - Phone:510-791-6332
Mailing Address - Fax:510-791-1923
Practice Address - Street 1:39140 PASEO PADRE PKWY
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1612
Practice Address - Country:US
Practice Address - Phone:510-791-6332
Practice Address - Fax:510-791-1923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26299111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherSOCIAL SECURITY
CADC0214460Medicare ID - Type UnspecifiedMEDICARE