Provider Demographics
NPI:1720294861
Name:FINNELL CHIROPRACTIC GROUP
Entity Type:Organization
Organization Name:FINNELL CHIROPRACTIC GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:FINNELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:916-989-1014
Mailing Address - Street 1:1000 RIVER ROCK DR
Mailing Address - Street 2:SUITE #115
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-2093
Mailing Address - Country:US
Mailing Address - Phone:916-989-1014
Mailing Address - Fax:916-989-1461
Practice Address - Street 1:1000 RIVER ROCK DR
Practice Address - Street 2:SUITE #115
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-2093
Practice Address - Country:US
Practice Address - Phone:916-989-1014
Practice Address - Fax:916-989-1461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23517111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1306986948OtherINDIVIDUAL NPI
CAZZZ55590ZOtherBLUE SHIELD PROVIDER #
CADC0235170Medicare ID - Type Unspecified
CA1306986948OtherINDIVIDUAL NPI