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General NPI Number Information
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NPI Number | 1013173749
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Entity Type | Organization
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Legal Business Name | BEALE FAMILY CHIROPRACTIC INC
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Dates
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Enumeration Date | 08/01/2008
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Last Update Date | 08/01/2008
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Provider Practice Location Address
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Address Line | 22323 SHERMAN WAY STE 4
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City | CANOGA PARK
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State | CA
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Zip | 91303-4302
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Country | US
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Telephone | 818-883-5730
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Fax | 818-883-1689
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Provider Business Mailing Address
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Address Line | 22323 SHERMAN WAY STE 4
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City | CANOGA PARK
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State | CA
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Zip | 91303-4302
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Country | US
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Telephone | 818-883-5730
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Fax | 818-883-1689
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | RONALD LEE BEALE
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Credential | D.C.
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Telephone | 818-883-5730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 19046
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License Number State | CA
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