Provider Demographics
NPI:1447344007
Name:TOMASSETTI, VICTOR J (DC)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:J
Last Name:TOMASSETTI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2741 VISTA WAY
Mailing Address - Street 2:SUITE 111
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054
Mailing Address - Country:US
Mailing Address - Phone:760-757-0222
Mailing Address - Fax:
Practice Address - Street 1:2204 S EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-6306
Practice Address - Country:US
Practice Address - Phone:760-757-0222
Practice Address - Fax:760-757-0224
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14514111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT05406Medicare UPIN