Healthcare Provider Details

I. General information

NPI: 1700955754
Provider Name (Legal Business Name): FOXLEY & BUTCHART MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34563 ALVARADO NILES RD
UNION CITY CA
94587-4575
US

IV. Provider business mailing address

34563 ALVARADO NILES RD
UNION CITY CA
94587-4575
US

V. Phone/Fax

Practice location:
  • Phone: 510-487-5105
  • Fax: 510-487-5106
Mailing address:
  • Phone: 510-487-5105
  • Fax: 510-487-5106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC27315
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberC29434
License Number StateCA

VIII. Authorized Official

Name: DR. DENNIS BUTCHART
Title or Position: OWNER
Credential: D.C.
Phone: 510-487-5105