Provider Demographics
NPI:1881720365
Name:NAVE CHIROPRACTIC INC
Entity type:Organization
Organization Name:NAVE CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:M
Authorized Official - Last Name:NAVE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:909-989-0944
Mailing Address - Street 1:8977 FOOTHILL BLVD
Mailing Address - Street 2:#D
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-3498
Mailing Address - Country:US
Mailing Address - Phone:909-989-0944
Mailing Address - Fax:909-980-9669
Practice Address - Street 1:8977 FOOTHILL BLVD
Practice Address - Street 2:#D
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-3498
Practice Address - Country:US
Practice Address - Phone:909-989-0944
Practice Address - Fax:909-980-9669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC15672111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0156720OtherINSURANCE BC BS
CADC0156720OtherINSURANCE BC BS
CAT05876Medicare UPIN