| Cook Upper Cervical Chiropractic, Apc | |
|
409 Camino Del Rio S Ste 105 San Diego CA 92108-3505 | |
| (858) 577-0662 | |
| Not Available |
| Full Name | Cook Upper Cervical Chiropractic, Apc |
|---|---|
| Speciality | Clinic/Center |
| Location | 409 Camino Del Rio S Ste 105, San Diego, California |
| Authorized Official Name and Position | Mercedes Cook (PRESIDENT) |
| Authorized Official Contact | 9377262798 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cook Upper Cervical Chiropractic, Apc 409 Camino Del Rio S Ste 105 San Diego CA 92108-3505 Ph: () - | Cook Upper Cervical Chiropractic, Apc 409 Camino Del Rio S Ste 105 San Diego CA 92108-3505 Ph: (858) 577-0662 |
| NPI Number | 1164056792 |
|---|---|
| Provider Enumeration Date | 02/22/2020 |
| Last Update Date | 02/22/2020 |
| Medicare PECOS PAC ID | 0840618963 |
|---|---|
| Medicare Enrollment ID | O20200922000507 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164056792 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Mercedes Alexis Cook |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1922504745 PECOS PAC ID: 6507129848 Enrollment ID: I20200922000545 |
| Provider Name | Denicio Gonzalez-drake |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1023733722 PECOS PAC ID: 9638546369 Enrollment ID: I20221222001464 |
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