Provider Demographics
NPI:1538433081
Name:CHAMBERS CHIROPRACTIC CENTER, INC.
Entity type:Organization
Organization Name:CHAMBERS CHIROPRACTIC CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:D
Authorized Official - Last Name:CHAMBERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:408-270-8795
Mailing Address - Street 1:2670 S WHITE RD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-2071
Mailing Address - Country:US
Mailing Address - Phone:408-270-8795
Mailing Address - Fax:408-223-1970
Practice Address - Street 1:2670 S WHITE RD
Practice Address - Street 2:SUITE 160
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95148-2071
Practice Address - Country:US
Practice Address - Phone:408-270-8795
Practice Address - Fax:408-223-1970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-01
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19077111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0190770Medicare UPIN
CAU30994Medicare UPIN