Provider Demographics
NPI:1679519029
Name:RAINES, ERIC S (DC)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:S
Last Name:RAINES
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 1:77 BIRCH STREET
Mailing Address - Street 2:STE C
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94062-4000
Mailing Address - Country:US
Mailing Address - Phone:650-562-7607
Mailing Address - Fax:650-995-7257
Practice Address - Street 1:77 BIRCH STREET
Practice Address - Street 2:STE C
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062-4000
Practice Address - Country:US
Practice Address - Phone:650-562-7607
Practice Address - Fax:650-995-7257
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC0136510111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor