MEDICARE: INNATE CHIROPRACTIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1558237818
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNATE CHIROPRACTIC

Provider Business Mailing Address
First Line	:	916 SAN PABLO AVE UNIT A
Second Line	:
City	:	ALBANY
State	:	CA
Zip	:	94706-2059
Country	:	US
Telephone Number	:	510-528-5216
Fax Number	:	510-528-5256

Provider Business Practice Location Address
First Line	:	916 SAN PABLO AVE UNIT A
Second Line	:
City	:	ALBANY
State	:	CA
Zip	:	94706-2059
Country	:	US
Telephone Number	:	510-528-5216
Fax Number	:	510-528-5256

Authorized Official
Title or Position	:	OWNER/CHIROPRACTOR
Name	:	STEFAN B COHEN
Credential	:	DC
Telephone Number	:	510-528-5216

Provider Enumeration Date	:	10/14/2025
Last Update Date	:	10/14/2025

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Directions to “INNATE CHIROPRACTIC ” Practice Location

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