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General NPI Number Information
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NPI Number | 1679919583
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Entity Type | Organization
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Legal Business Name | HERRERA CHIROPRACTIC INC
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Dates
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Enumeration Date | 05/18/2013
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Last Update Date | 05/18/2013
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Provider Practice Location Address
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Address Line | 416 N H ST SUITE #1
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City | SAN BERNARDINO
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State | CA
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Zip | 92410-3268
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Country | US
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Telephone | 909-888-5527
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Fax | 909-743-6941
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Provider Business Mailing Address
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Address Line | 416 N H ST SUITE #1
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City | SAN BERNARDINO
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State | CA
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Zip | 92410-3268
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Country | US
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Telephone | 909-888-5527
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Fax | 909-743-6941
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. JOSE HERRERA
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Credential | D.C.
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Telephone | 909-888-5527
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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 | DC27442
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License Number State | CA
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