Healthcare Provider Details

I. General information

NPI: 1366776767
Provider Name (Legal Business Name): VICTOR BJ KRAUSS CHIROPRACTIC, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2009
Last Update Date: 11/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6753 EL CAJON BLVD
SAN DIEGO CA
92115-1621
US

IV. Provider business mailing address

6753 EL CAJON BLVD
SAN DIEGO CA
92115-1621
US

V. Phone/Fax

Practice location:
  • Phone: 619-584-4847
  • Fax: 619-407-7993
Mailing address:
  • Phone: 619-584-4847
  • Fax: 619-407-7993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number23290
License Number StateCA

VIII. Authorized Official

Name: DR. VICTOR BENJAMIN JOSHUA KRAUSS
Title or Position: DIRECTOR
Credential: D.C.
Phone: 619-584-4847