Healthcare Provider Details

I. General information

NPI: 1164726550
Provider Name (Legal Business Name): DORRIS CHIROPRACTIC INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2010
Last Update Date: 06/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10330 FRIARS RD STE 111
SAN DIEGO CA
92120
US

IV. Provider business mailing address

10330 FRIARS RD STE 111
SAN DIEGO CA
92120-2300
US

V. Phone/Fax

Practice location:
  • Phone: 619-281-7800
  • Fax:
Mailing address:
  • Phone: 619-281-7800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREA BAIOTTO DORRIS
Title or Position: OWNER/PRESIDENT
Credential: DC
Phone: 619-281-7800