Healthcare Provider Details

I. General information

NPI: 1659950954
Provider Name (Legal Business Name): ESPINOZA CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 04/05/2021
Certification Date: 04/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530A 5TH ST
BERKELEY CA
94710-1713
US

IV. Provider business mailing address

4061 E CASTRO VALLEY BLVD # 140
CASTRO VALLEY CA
94552-4840
US

V. Phone/Fax

Practice location:
  • Phone: 510-305-4772
  • Fax: 510-943-5252
Mailing address:
  • Phone: 510-305-4772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: MR. EDWARD ESPINOZA II
Title or Position: PRESIDENT
Credential:
Phone: 510-305-4772