Healthcare Provider Details

I. General information

NPI: 1609541614
Provider Name (Legal Business Name): RESILIENCE CHIROPRACTIC LUONG
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2021
Last Update Date: 11/13/2021
Certification Date: 11/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 CARMAR ST
HAYWARD CA
94544-5808
US

IV. Provider business mailing address

1040 DAVIS ST STE 201
SAN LEANDRO CA
94577-1519
US

V. Phone/Fax

Practice location:
  • Phone: 510-789-7789
  • Fax:
Mailing address:
  • Phone: 510-789-7789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ERNEST LUONG
Title or Position: CHIROPRACTOR
Credential: DC
Phone: 510-789-7789