Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC29377 | CA |
N | 111NS0005X | Chiropractic Sports Physician | DC29377 | CA |
NPI | 1215169222 |
---|---|
Provider Name | Dr. Trevor Bachmeyer |
First Address | Walnut Creek, CA 94596-7314 |
Second Address | Walnut Creek, CA 94596-7314 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2009 |
Last Update Date | 10/08/2009 |