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General NPI Number Information
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NPI Number | 1548599145
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Entity Type | Organization
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Legal Business Name | PENINSULA SPINE & SPORTS REHAB, A ROMMEL HINDOCHA CHIROPRACTIC CORP.
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Dates
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Enumeration Date | 12/10/2009
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Last Update Date | 12/10/2009
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Provider Practice Location Address
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Address Line | 101 S SAN MATEO DR SUITE 200
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City | SAN MATEO
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State | CA
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Zip | 94401-3819
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Country | US
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Telephone | 650-347-2225
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Fax | 650-242-8802
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Provider Business Mailing Address
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Address Line | 101 S SAN MATEO DR SUITE 200
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City | SAN MATEO
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State | CA
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Zip | 94401-3819
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Country | US
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Telephone | 650-347-2225
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Fax | 650-242-8802
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. ROMMEL HINDOCHA
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Credential | D.C.
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Telephone | 650-347-2225
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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 | DC-28240
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License Number State | CA
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