Provider Demographics
NPI:1144680380
Name:CLOUDS REST HEALING CENTER ACUPUNCTURE & CHIROPRACTIC, INC
Entity type:Organization
Organization Name:CLOUDS REST HEALING CENTER ACUPUNCTURE & CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZARAGOZA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:415-297-5059
Mailing Address - Street 1:2717 JUDAH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-1433
Mailing Address - Country:US
Mailing Address - Phone:415-661-0608
Mailing Address - Fax:415-661-0826
Practice Address - Street 1:2717 JUDAH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-1433
Practice Address - Country:US
Practice Address - Phone:415-661-0608
Practice Address - Fax:415-661-0826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-01
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21847111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0218470Medicare UPIN