Provider Demographics
NPI:1700987997
Name:PLACER CHRIPRACTIC
Entity type:Organization
Organization Name:PLACER CHRIPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR. AND OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERROD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:916-435-1522
Mailing Address - Street 1:2221 SUNSET BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-4784
Mailing Address - Country:US
Mailing Address - Phone:916-435-1522
Mailing Address - Fax:916-435-2216
Practice Address - Street 1:2221 SUNSET BLVD
Practice Address - Street 2:STE 103
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-4784
Practice Address - Country:US
Practice Address - Phone:916-435-1522
Practice Address - Fax:916-435-2216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25533111N00000X
CADC27169111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0255330Medicare ID - Type UnspecifiedDR. KURT WEBB
CADC0271690Medicare UPIN
CADC0255330Medicare UPIN
CADC0271690Medicare ID - Type Unspecified