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General NPI Number Information
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NPI Number | 1245198589
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Entity Type | Organization
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Legal Business Name | TIDE AND PINE CHIROPRACTIC LLC
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Dates
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Enumeration Date | 01/14/2026
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 14141 OLD EL CAMINO REAL UNIT 22
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City | SAN DIEGO
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State | CA
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Zip | 92130-3294
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Country | US
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Telephone | 760-278-3133
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Fax |
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Provider Business Mailing Address
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Address Line | 14141 OLD EL CAMINO REAL UNIT 22
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City | SAN DIEGO
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State | CA
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Zip | 92130-3294
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Country | US
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Telephone | 760-278-3133
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | PATRICK KASEY PIERCE
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Credential | DC
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Telephone | 760-278-3133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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