Provider Demographics
NPI:1780794180
Name:BAYRAK, TOSUN THOMAS (DC)
Entity type:Individual
Prefix:DR
First Name:TOSUN
Middle Name:THOMAS
Last Name:BAYRAK
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 1:12750 CARMEL COUNTRY RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-2159
Mailing Address - Country:US
Mailing Address - Phone:858-481-4124
Mailing Address - Fax:858-481-7354
Practice Address - Street 1:12750 CARMEL COUNTRY RD
Practice Address - Street 2:SUITE 207
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-2159
Practice Address - Country:US
Practice Address - Phone:858-481-4124
Practice Address - Fax:858-481-7354
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC15822111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000107379Medicare ID - Type Unspecified
CA504102Medicare ID - Type UnspecifiedECLAIM MEDICARE SUBMITTER
CAT18157Medicare UPIN