Healthcare Provider Details

I. General information

NPI: 1770020083
Provider Name (Legal Business Name): ANDRIJANA JEVTIC PITRUZZELLO DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DR. ANDRIJANA JEVTIC

II. Dates (important events)

Enumeration Date: 01/24/2017
Last Update Date: 04/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5175 E PACIFIC COAST HWY SUITE 106
LONG BEACH CA
90804-3317
US

IV. Provider business mailing address

5175 E PACIFIC COAST HWY SUITE 106
LONG BEACH CA
90804-3317
US

V. Phone/Fax

Practice location:
  • Phone: 562-270-5840
  • Fax:
Mailing address:
  • Phone: 562-270-5840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number32642
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number32642
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: