=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033419015
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RODNEY L. CUMMINGS, D.C. CHIROPRACTIC CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/25/2010
-----------------------------------------------------
Last Update Date | 10/25/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 26045 BOUQUET CANYON RD
-----------------------------------------------------
City | SAUGUS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91350-2639
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-254-6107
-----------------------------------------------------
Fax | 661-255-2805
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 26045 BOUQUET CANYON RD
-----------------------------------------------------
City | SAUGUS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91350-2639
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-254-6107
-----------------------------------------------------
Fax | 661-255-2805
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. RODNEY LLOYD CUMMINGS
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 661-254-6107
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | DC17084
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------