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General NPI Number Information
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NPI Number | 1336384007
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Entity Type | Organization
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Legal Business Name | CANYON CHIROPRACTIC
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Dates
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Enumeration Date | 12/10/2008
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Last Update Date | 12/10/2008
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Provider Practice Location Address
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Address Line | 2570 SAN RAMON VALLEY BLVD SUITE A-106
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City | SAN RAMON
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State | CA
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Zip | 94583-1637
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Country | US
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Telephone | 925-867-1414
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Fax | 925-867-1420
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Provider Business Mailing Address
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Address Line | 2570 SAN RAMON VALLEY BLVD SUITE A-106
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City | SAN RAMON
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State | CA
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Zip | 94583-1637
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Country | US
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Telephone | 925-867-1414
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Fax | 925-867-1420
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | DR. ROBERT C. DEES
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Credential | D.C.
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Telephone | 925-867-1414
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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 | DC21292
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License Number State | CA
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