Provider Demographics
NPI:1841621620
Name:SOMA SPORT AND PHYSIO ENG CHIROPRACTIC INC
Entity type:Organization
Organization Name:SOMA SPORT AND PHYSIO ENG CHIROPRACTIC INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ENG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:415-252-4333
Mailing Address - Street 1:290 DIVISION ST STE 103
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-4892
Mailing Address - Country:US
Mailing Address - Phone:415-252-4333
Mailing Address - Fax:415-626-4736
Practice Address - Street 1:290 DIVISION ST STE 103
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-4892
Practice Address - Country:US
Practice Address - Phone:415-252-4333
Practice Address - Fax:415-626-4736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-04
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27752111N00000X
CAPT40287225100000X
CAPT38784225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty