Healthcare Provider Details

I. General information

NPI: 1164689832
Provider Name (Legal Business Name): VRANKOVICH CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2008
Last Update Date: 06/27/2023
Certification Date: 06/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 OAK ST STE C2
OAKLAND CA
94607-4635
US

IV. Provider business mailing address

PO BOX 11105
OAKLAND CA
94611-0105
US

V. Phone/Fax

Practice location:
  • Phone: 510-655-3456
  • Fax:
Mailing address:
  • Phone: 510-655-3456
  • Fax: 510-655-3464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number31096
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number25378
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number3084552
License Number StateCA

VIII. Authorized Official

Name: DR. GREG VRANKOVICH
Title or Position: PRESIDENT
Credential: DC
Phone: 510-655-3456