# BIRCH PAIN & SPINE GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871188862
- **Authorized official:** DR. LINA YOUSOFI DC (VOICE PRESIDENT)
- **Authorized official phone:** (209) 830-1799

## Contact information

- **Practice address:** 227 E 11TH ST, TRACY, CA 95376-4015
- **Practice address phone:** (209) 830-1799
- **Practice address fax:** (209) 835-5034
- **Mailing address:** 227 E 11TH ST, TRACY, CA 95376-4015
- **Mailing address phone:** (209) 830-1799
- **Mailing address fax:** (209) 835-5034

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 246Z00000X | Other Specialist/Technologist | — | NULL | Yes |
| 246Z00000X | Other Specialist/Technologist | — | — | Yes |

## Other

- **Enumeration date:** 03/02/2021
- **Last updated:** 03/02/2021