Healthcare Provider Details

I. General information

NPI: 1477648046
Provider Name (Legal Business Name): TRU-HEALTH ENTERPRISES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5523 MISSION RD STE C
BONSALL CA
92003
US

IV. Provider business mailing address

P.O.BOX 338
BONSALL CA
92003-0338
US

V. Phone/Fax

Practice location:
  • Phone: 760-724-8104
  • Fax:
Mailing address:
  • Phone: 760-724-8104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number21391
License Number StateCA

VIII. Authorized Official

Name: DEREK E KING
Title or Position: PRES
Credential: D.C.
Phone: 760-724-8104