Healthcare Provider Details
I. General information
NPI: 1760697742
Provider Name (Legal Business Name): BPU, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1301 SOLANO AVE
ALBANY CA
94706-1825
US
IV. Provider business mailing address
1301 SOLANO AVE
ALBANY CA
94706-1825
US
V. Phone/Fax
- Phone: 510-526-6657
- Fax:
- Phone: 510-526-6657
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NN1001X |
| Taxonomy | Nutrition Chiropractor |
| License Number | 14314 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
LINDA
BERRY
Title or Position: OWNER
Credential: DC, CCN
Phone: 510-526-6657