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General NPI Number Information
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NPI Number | 1114153558
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Entity Type | Individual
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Provider Name | TED NABEWARI D.C.
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Gender | Male
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Dates
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Enumeration Date | 05/29/2009
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Last Update Date | 05/29/2009
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Provider Practice Location Address
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Address Line | 643 S BUTTE ST
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City | SAN PEDRO
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State | CA
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Zip | 90732-3510
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Country | US
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Telephone | 310-831-5700
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Fax |
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Provider Business Mailing Address
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Address Line | 222 S CENTRAL AVE 140
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City | LOS ANGELES
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State | CA
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Zip | 90012-4229
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Country | US
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Telephone | 213-284-9888
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 31243
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License Number State | CA
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