Provider Demographics
NPI:1144633447
Name:VITZ CHIROPRACTIC AND REHABILITATION, INC.
Entity type:Organization
Organization Name:VITZ CHIROPRACTIC AND REHABILITATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:VITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:510-444-2663
Mailing Address - Street 1:401 29TH ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3519
Mailing Address - Country:US
Mailing Address - Phone:510-444-2663
Mailing Address - Fax:510-444-0747
Practice Address - Street 1:401 29TH ST
Practice Address - Street 2:SUITE 205
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3519
Practice Address - Country:US
Practice Address - Phone:510-444-2663
Practice Address - Fax:510-444-0747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-04
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29962111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1598992323OtherNPPES