Provider Demographics
NPI:1215782156
Name:BALCH CHIROPRACTIC PC
Entity type:Organization
Organization Name:BALCH CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:BALCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:650-219-0727
Mailing Address - Street 1:199 CALIFORNIA DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MILLBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94030-3118
Mailing Address - Country:US
Mailing Address - Phone:650-219-0727
Mailing Address - Fax:650-692-6237
Practice Address - Street 1:199 CALIFORNIA DR STE 100
Practice Address - Street 2:
Practice Address - City:MILLBRAE
Practice Address - State:CA
Practice Address - Zip Code:94030-3118
Practice Address - Country:US
Practice Address - Phone:650-219-0727
Practice Address - Fax:650-692-6237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service