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Organization
MARK E GRAY DC CHIROPRACTIC CORP
Active
Organization
MARK E GRAY DC CHIROPRACTIC CORP
Active
Other names
Chiro Fitness
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN S OTA DC (CHIROPRACTIC DOCTOR)
(408) 720-0941
Entity
Organization
Contact information
Practice address
150 E FREMONT AVE, SUNNYVALE, CA 94087
(408) 720-0941
(408) 991-0966
Mailing address
1052 E EL CAMINO REAL, SUNNYVALE, CA 94087
(408) 248-7960
(408) 554-0654
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
23084
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ40577Z
BLUE SHIELD
CA
Enumeration date
12/08/2006
Last updated
10/12/2007
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