Provider Demographics
NPI:1316154925
Name:BAAR, RUSSEL D (DC)
Entity type:Individual
Prefix:DR
First Name:RUSSEL
Middle Name:D
Last Name:BAAR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 SALINAS ST A
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-2681
Mailing Address - Country:US
Mailing Address - Phone:831-424-0496
Mailing Address - Fax:831-424-0499
Practice Address - Street 1:2 SALINAS ST A
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2681
Practice Address - Country:US
Practice Address - Phone:831-424-0496
Practice Address - Fax:831-424-0499
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15859111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ20295ZMedicare ID - Type Unspecified