Provider Demographics
NPI:1982292595
Name:INFINITE BODY HEALTH
Entity Type:Organization
Organization Name:INFINITE BODY HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:GLADYS
Authorized Official - Middle Name:MINUET
Authorized Official - Last Name:SEPULVEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-622-9050
Mailing Address - Street 1:2100 CARLMONT DR STE 3
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94002-3465
Mailing Address - Country:US
Mailing Address - Phone:650-622-9050
Mailing Address - Fax:
Practice Address - Street 1:2100 CARLMONT DR STE 3
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:CA
Practice Address - Zip Code:94002-3465
Practice Address - Country:US
Practice Address - Phone:650-622-9050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty