Provider Demographics
NPI:1487675476
Name:JEFFREY KATZ CHIROPRACTIC INC
Entity type:Organization
Organization Name:JEFFREY KATZ CHIROPRACTIC INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:NGHIEM-SHUM
Authorized Official - Suffix:
Authorized Official - Credentials:DC LAC QME
Authorized Official - Phone:415-584-3042
Mailing Address - Street 1:4879 MISSION ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112
Mailing Address - Country:US
Mailing Address - Phone:415-584-3042
Mailing Address - Fax:415-584-3052
Practice Address - Street 1:4879 MISSION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94112
Practice Address - Country:US
Practice Address - Phone:415-584-3042
Practice Address - Fax:415-584-3052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC14657111N00000X
CAAC8015171100000X
CADC27496111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ29393ZOtherMEDICARE PTAN
U94641Medicare UPIN
T05459Medicare UPIN