Provider Demographics
NPI:1053913798
Name:BRIAN R BAAR CHIROPRACTIC APC
Entity type:Organization
Organization Name:BRIAN R BAAR CHIROPRACTIC APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:BAAR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:619-500-4615
Mailing Address - Street 1:955 LANE AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91914-4525
Mailing Address - Country:US
Mailing Address - Phone:619-500-4615
Mailing Address - Fax:619-414-1387
Practice Address - Street 1:955 LANE AVE STE 101
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914-4525
Practice Address - Country:US
Practice Address - Phone:619-500-4615
Practice Address - Fax:619-414-1387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA65398OtherCERTIFICATION/LICENSE NUMBER
CADC32129OtherCERTIFICATION/LICENSE NUMBER
CAAC16429OtherCERTIFICATION/LICENSE NUMBER