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NPI Code Detail

MEDICARE: ACTIVE CHIROPRACTIC AND WELLNESS CENTER

MEDICARE: ACTIVE CHIROPRACTIC AND WELLNESS CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorDC-30203CA

General Provider Information

NPI Number : 1588810782
Entity Type Code : Organization
Provider Name (Legal Business Name) : ACTIVE CHIROPRACTIC AND WELLNESS CENTER
Provider Business Mailing Address
First Line : 2440 LAS POSAS RD
Second Line :
City : CAMARILLO
State : CA
Zip : 93010-3458
Country : US
Telephone Number : 805-384-0101
Fax Number : 805-384-0220
Provider Business Practice Location Address
First Line : 2440 LAS POSAS RD
Second Line :
City : CAMARILLO
State : CA
Zip : 93010-3458
Country : US
Telephone Number : 805-384-0101
Fax Number : 805-384-0220
Authorized Official
Title or Position : DOCTOR
Name : ROMEO ECLAVEA DIMAANO
Credential : DC
Telephone Number : 805-384-0101
Provider Enumeration Date : 08/07/2008
Last Update Date : 08/07/2008

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Directions to “ACTIVE CHIROPRACTIC AND WELLNESS CENTER ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.