Healthcare Provider Details

I. General information

NPI: 1053913798
Provider Name (Legal Business Name): BRIAN R BAAR CHIROPRACTIC APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2020
Last Update Date: 11/09/2020
Certification Date: 11/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

955 LANE AVE STE 101
CHULA VISTA CA
91914-4525
US

IV. Provider business mailing address

955 LANE AVE STE 101
CHULA VISTA CA
91914-4525
US

V. Phone/Fax

Practice location:
  • Phone: 619-500-4615
  • Fax: 619-414-1387
Mailing address:
  • Phone: 619-500-4615
  • Fax: 619-414-1387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. BRIAN RICHARD BAAR
Title or Position: OWNER/PRESIDENT
Credential: DC
Phone: 619-500-4615