Healthcare Provider Details

I. General information

NPI: 1053481671
Provider Name (Legal Business Name): ALICIA ANDREIS PFLUEGER D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 TIBURON BLVD
TIBURON CA
94920-2515
US

IV. Provider business mailing address

1640 TIBURON BLVD
TIBURON CA
94920-2515
US

V. Phone/Fax

Practice location:
  • Phone: 415-435-7420
  • Fax:
Mailing address:
  • Phone: 415-435-7420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number21624
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: