Provider Demographics
NPI:1447482401
Name:NORTHERN CALIFORNIA INJURY CENTERS INC.
Entity type:Organization
Organization Name:NORTHERN CALIFORNIA INJURY CENTERS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SALVATORE
Authorized Official - Middle Name:
Authorized Official - Last Name:NOLFO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:510-276-4845
Mailing Address - Street 1:1460 150TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-1821
Mailing Address - Country:US
Mailing Address - Phone:510-276-4845
Mailing Address - Fax:510-276-8452
Practice Address - Street 1:1690 TEXAS ST STE 1W
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-5947
Practice Address - Country:US
Practice Address - Phone:707-427-2600
Practice Address - Fax:707-427-2662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-10
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26505111N00000X
CADC28710111N00000X
CADC28302111N00000X
CAAC9224171100000X
CAAC5501171100000X
CAC42153207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty