Healthcare Provider Details

I. General information

NPI: 1457343022
Provider Name (Legal Business Name): ANTHONY JOHN PIRRITANO D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2005
Last Update Date: 09/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2250 S MAIN ST STE 203
CORONA CA
92882-2534
US

IV. Provider business mailing address

38830 CALLE DE COMPANERO
MURRIETA CA
92562-8877
US

V. Phone/Fax

Practice location:
  • Phone: 951-737-1252
  • Fax: 951-737-2820
Mailing address:
  • Phone: 951-677-6299
  • Fax: 951-737-2820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number22125
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: