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General NPI Number Information
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NPI Number | 1801543590
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Entity Type | Organization
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Legal Business Name | SUM FAMILY CHIROPRACTIC
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Dates
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Enumeration Date | 03/03/2022
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Last Update Date | 03/03/2022
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Provider Practice Location Address
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Address Line | 20406 REDWOOD RD STE D
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-4317
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Country | US
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Telephone | 510-538-1111
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Fax | 510-538-1112
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Provider Business Mailing Address
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Address Line | 20406 REDWOOD RD STE D
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-4317
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Country | US
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Telephone | 510-538-1111
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Fax | 510-538-1112
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Authorized Official
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Title or Position | CEO
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Name | MARISA SUM
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Credential | DC
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Telephone | 510-912-0741
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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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