Healthcare Provider Details

I. General information

NPI: 1518673383
Provider Name (Legal Business Name): GOLDBERG PAWSITIVE TOUCH CHIROPRACTIC P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2023
Last Update Date: 01/25/2023
Certification Date: 01/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1109 8TH ST
CORONADO CA
92118-2217
US

IV. Provider business mailing address

4 BRIDGETOWN BND
CORONADO CA
92118-3258
US

V. Phone/Fax

Practice location:
  • Phone: 619-537-6833
  • Fax:
Mailing address:
  • Phone: 619-820-8477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: CASSANDRA GOLDBERG
Title or Position: PRESIDENT/OWNER
Credential: D.C.
Phone: 619-820-8477