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10988 Combie Rd Ste 100 Auburn CA 95602-8987 | |
(530) 268-1386 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 10988 Combie Rd Ste 100, Auburn, California |
Authorized Official Name and Position | Dallan R Packard (CHIROPRACTOR) |
Authorized Official Contact | 5302681386 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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10988 Combie Rd Ste 100 Auburn CA 95602-8987 Ph: (530) 268-1386 | 10988 Combie Rd Ste 100 Auburn CA 95602-8987 Ph: (530) 268-1386 |
NPI Number | 1093992083 |
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Provider Enumeration Date | 01/22/2008 |
Last Update Date | 07/21/2022 |
Medicare PECOS PAC ID | 4486928363 |
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Medicare Enrollment ID | O20170915000468 |
Identifier | Type | State | Issuer |
---|---|---|---|
1093992083 | NPI | - | NPPES |
000056381 | Other | UT | INDIVIDUAL MEDICARE NUMBE |
000058112 | Other | UT | GROUP MEDICARE NUMBER |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | 33888 (California) | Primary |
Provider Name | Dallan Raymond Packard |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1861421703 PECOS PAC ID: 5092734921 Enrollment ID: I20170920003587 |
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