Basic Information
Provider Information
NPI: 1568138881
EntityType: 2
ReplacementNPI:  
OrganizationName: RABBETZ SPORTS CHIROPRACTIC INC
LastName:  
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Credential:  
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Mailing Information
Address1: THREE EMBARCADERO CENTER, LL5
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 94111
CountryCode: US
TelephoneNumber: 4154952225
FaxNumber: 4154952228
Practice Location
Address1: THREE EMBARCADERO CENTER, LOBBY LEVEL
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 94111
CountryCode: US
TelephoneNumber: 4154952225
FaxNumber: 4154952228
Other Information
ProviderEnumerationDate: 08/17/2021
LastUpdateDate: 08/17/2021
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: RABBETZ
AuthorizedOfficialFirstName: TAYLOR
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 4154952225
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: DC
NPICertificationDate: 08/17/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
111N00000X  Y193400000X SINGLE SPECIALTY GROUPChiropractic ProvidersChiropractor 

No ID Information.


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