=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891921326
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GREGG J. CARB CHIROPRACTIC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/10/2009
-----------------------------------------------------
Last Update Date | 06/26/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 220 SANSOME ST STE 530
-----------------------------------------------------
City | SAN FRANCISCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94104-2720
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-362-5092
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 220 SANSOME ST STE 530
-----------------------------------------------------
City | SAN FRANCISCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94104-2720
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-362-5092
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICER
-----------------------------------------------------
Name | DR. GREGG J. CARB
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 415-362-5092
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | DC0170470
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------