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General NPI Number Information
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NPI Number | 1942895768
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Entity Type | Organization
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Legal Business Name | ERIC GROSS CHIROPRACTIC INC
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Dates
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Enumeration Date | 03/03/2021
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Last Update Date | 03/03/2021
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Provider Practice Location Address
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Address Line | 6376 DEL CERRO BLVD
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City | SAN DIEGO
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State | CA
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Zip | 92120-4703
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Country | US
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Telephone | 619-582-2172
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Fax | 619-582-2207
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Provider Business Mailing Address
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Address Line | 6376 DEL CERRO BLVD
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City | SAN DIEGO
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State | CA
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Zip | 92120-4703
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Country | US
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Telephone | 619-582-2172
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Fax | 619-582-2207
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MRS. ELAINE STANGLER
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Credential | CMB, CCCPC
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Telephone | 619-851-2199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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