1508968025 NPI number — DR. BRIAN K BELLINGER D.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508968025 NPI number — DR. BRIAN K BELLINGER D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BELLINGER
Provider First Name:
BRIAN
Provider Middle Name:
K
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508968025
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/29/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
600 F STREET
Provider Second Line Business Mailing Address:
SUITE 3, PMB737
Provider Business Mailing Address City Name:
ARCATA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95521
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
707-308-2992
Provider Business Mailing Address Fax Number:
707-800-6640

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
822 G ST STE 11
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARCATA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95521-6224
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-308-2992
Provider Business Practice Location Address Fax Number:
707-800-6640
Provider Enumeration Date:
09/04/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  DC27012 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 357303900 . This is a "FEDERAL WORKERS' COMP" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: DC27012 . This is a "CA CHIROPRACTIC LICENSE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: DC0270120 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".