Healthcare Provider Details

I. General information

NPI: 1609172949
Provider Name (Legal Business Name): KALRA CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2011
Last Update Date: 02/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

639 W 9TH ST
SAN PEDRO CA
90731
US

IV. Provider business mailing address

639 W 9TH ST
SAN PEDRO CA
90731
US

V. Phone/Fax

Practice location:
  • Phone: 310-831-1447
  • Fax:
Mailing address:
  • Phone: 310-831-1447
  • Fax: 310-831-5728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC-27928
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC11228
License Number State

VIII. Authorized Official

Name: AJAY KALRA
Title or Position: CHIROPRACTOR/PRESIDENT
Credential:
Phone: 310-831-1447