Healthcare Provider Details

I. General information

NPI: 1811529829
Provider Name (Legal Business Name): LA PAZ CHIROPRACTIC AND REHABILITATION, INC. PREZIOSI, ADAMO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2020
Last Update Date: 07/01/2020
Certification Date: 07/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25251 PASEO DE ALICIA STE 204
LAGUNA HILLS CA
92653-4616
US

IV. Provider business mailing address

25251 PASEO DE ALICIA STE 204
LAGUNA HILLS CA
92653-4616
US

V. Phone/Fax

Practice location:
  • Phone: 949-770-8767
  • Fax: 949-415-7899
Mailing address:
  • Phone: 949-770-8767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STACY PAYNE
Title or Position: MANAGER
Credential:
Phone: 949-892-8644