1972893212 NPI number — VEIRS CHIROPRACTIC PC

Table of content: (NPI 1972893212)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972893212 NPI number — VEIRS CHIROPRACTIC PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VEIRS CHIROPRACTIC PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HAVEN CHIROPRACTIC CLINIC
Provider Other Organization Name Type Code:
3
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:
1972893212
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/07/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7388 CARNELIAN ST
Provider Second Line Business Mailing Address:
STE D
Provider Business Mailing Address City Name:
RANCHO CUCAMONGA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91730-1160
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
909-945-9982
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7388 CARNELIAN ST
Provider Second Line Business Practice Location Address:
STE D
Provider Business Practice Location Address City Name:
RANCHO CUCAMONGA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91730-1160
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-945-9982
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/07/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
VEIRS
Authorized Official First Name:
BRYAN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
909-945-9982

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , 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: 1740362987 . This is a "NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1386711943 . This is a "NPI" identifier . This identifiers is of the category "OTHER".