Healthcare Provider Details

I. General information

NPI: 1235445412
Provider Name (Legal Business Name): BALANCE CHIROPRACTIC HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2010
Last Update Date: 08/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4168 PIEDMONT AVE SUITE E
OAKLAND CA
94611-5172
US

IV. Provider business mailing address

4168 PIEDMONT AVE SUITE E
OAKLAND CA
94611-5172
US

V. Phone/Fax

Practice location:
  • Phone: 510-450-0701
  • Fax: 510-547-1039
Mailing address:
  • Phone: 510-450-0701
  • Fax: 510-547-1039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number7689824-1202
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberDC28197
License Number StateCA

VIII. Authorized Official

Name: DR. EVA L. WHITMORE
Title or Position: OWNER/DOCTOR
Credential: B.S., D.C.
Phone: 510-450-0701