Healthcare Provider Details

I. General information

NPI: 1013649870
Provider Name (Legal Business Name): NICOLAS SANTOS CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2022
Last Update Date: 06/29/2022
Certification Date: 06/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

THREE EMBARCADERO CENTER LOBBY LEVEL
SAN FRANCISCO CA
94111
US

IV. Provider business mailing address

3 EMBARCADERO CTR LBBY LL5
SAN FRANCISCO CA
94111-4080
US

V. Phone/Fax

Practice location:
  • Phone: 415-495-2225
  • Fax: 415-495-2228
Mailing address:
  • Phone: 415-495-2225
  • Fax: 415-495-2228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: NICOLAS SANTOS
Title or Position: OWNER
Credential: DC
Phone: 630-303-2301