Provider Demographics
NPI:1427107333
Name:CARRINO CHIROPRACTIC INC
Entity type:Organization
Organization Name:CARRINO CHIROPRACTIC INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:CARRINO
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:530-243-2300
Mailing Address - Street 1:153 HARTNELL AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-1856
Mailing Address - Country:US
Mailing Address - Phone:530-243-2300
Mailing Address - Fax:530-222-0318
Practice Address - Street 1:153 HARTNELL AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-1856
Practice Address - Country:US
Practice Address - Phone:530-243-2300
Practice Address - Fax:530-222-0318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 21651111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0216510Medicaid
CADC0216510Medicaid
CAU29241Medicare UPIN