1528179330 NPI number — DR. CARRIE LYN WHEELER ENGH D.C.

Table of content: DR. CARRIE LYN WHEELER ENGH D.C. (NPI 1528179330)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528179330 NPI number — DR. CARRIE LYN WHEELER ENGH D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WHEELER ENGH
Provider First Name:
CARRIE
Provider Middle Name:
LYN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WHEELER
Provider Other First Name:
CARRIE
Provider Other Middle Name:
LYN
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.C.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1528179330
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/15/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2410 FAIR OAKS BLVD
Provider Second Line Business Mailing Address:
STE 160
Provider Business Mailing Address City Name:
SACRAMENTO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95825-7630
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-483-2359
Provider Business Mailing Address Fax Number:
916-483-0329

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2410 FAIR OAKS BLVD
Provider Second Line Business Practice Location Address:
STE 160
Provider Business Practice Location Address City Name:
SACRAMENTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95825
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-483-2359
Provider Business Practice Location Address Fax Number:
916-483-0329
Provider Enumeration Date:
08/31/2006

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:  DC25534 , 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)





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