Organization Active NPI

Cafe of Life Chiropractic PC

  • Chiropractor
  • Bend, OR
National Provider Identifier
1194911743
Registry record updated Sep 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
273340 Issued in OR
Legal business name
CAFE OF LIFE CHIROPRACTIC PC
Practice address
519 NW Colorado Ave
Bend, OR 97701-3216
Phone
(541) 389-3894
Fax
(541) 389-5004
NPI assigned
Sep 18, 2007
Last updated
Sep 18, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. David Richard Boorstein, DCNPI 1841375797
Title
Chiropractor
Phone
(541) 389-3894

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 273340 OR Primary

Addresses

Primary practice location

519 NW Colorado Ave
Bend, OR 97701-3216

Mailing address

519 NW Colorado Ave
Bend, OR 97701-3216
Phone (541) 389-3894

National Provider Directory

National Provider Directory

Locations

519 NW Colorado Ave
Bend, OR 97703
Phone (541) 389-3894

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190073600000",
    "number": "1194911743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 NW COLORADO AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013216",
            "telephone_number": "541-389-3894",
            "fax_number": "541-389-5004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 NW COLORADO AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013216",
            "telephone_number": "541-389-3894",
            "fax_number": "541-389-5004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAFE OF LIFE CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-18",
        "last_updated": "2007-09-18",
        "status": "A",
        "authorized_official_last_name": "BOORSTEIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "541-389-3894",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "273340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.