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General NPI Number Information
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NPI Number | 1760719868
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Entity Type | Organization
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Legal Business Name | CORDOVA CHIROPRATI CENTRE
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Dates
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Enumeration Date | 11/10/2009
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Last Update Date | 11/10/2009
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Provider Practice Location Address
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Address Line | 9053 SOQUEL DR. SUITE 202
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City | APTOS
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State | CA
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Zip | 95033-4034
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Country | US
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Telephone | 831-688-2433
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Fax | 831-688-6165
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Provider Business Mailing Address
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Address Line | 9053 SOQUEL DR. SUITE 202
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City | APTOS
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State | CA
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Zip | 95033-4034
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Country | US
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Telephone | 831-688-2433
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Fax | 831-688-6165
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Authorized Official
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Title or Position | OWNER / DOCTOR
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Name | DR. ABRAHAM ARTHUR CORDOVA
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Credential | D.C.
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Telephone | 831-688-2433
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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 | 11710DC
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License Number State | CA
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