Provider Demographics
NPI:1730609538
Name:ABSOLUTE CHIROPRACTIC-DR PAMELA'S WELLNESS CENTER
Entity type:Organization
Organization Name:ABSOLUTE CHIROPRACTIC-DR PAMELA'S WELLNESS CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CHUMBEIRO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:925-200-6775
Mailing Address - Street 1:428 N L ST
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94551-2806
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:428 N L ST
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94551-2806
Practice Address - Country:US
Practice Address - Phone:925-960-9050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-22
Last Update Date:2017-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23710111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty