Healthcare Provider Details

I. General information

NPI: 1952549057
Provider Name (Legal Business Name): ELI BENTABOU DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2009
Last Update Date: 01/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4125 MOHR AVE SUITE F
PLEASANTON CA
94566-4749
US

IV. Provider business mailing address

4125 MOHR AVE SUITE F
PLEASANTON CA
94566-4749
US

V. Phone/Fax

Practice location:
  • Phone: 510-355-5326
  • Fax:
Mailing address:
  • Phone: 510-355-5326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License NumberDC 28558
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: