=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134310709
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NANIA CHIROPRACTIC INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/07/2007
-----------------------------------------------------
Last Update Date | 07/22/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 25200 CRENSHAW BLVD SUITE 101
-----------------------------------------------------
City | TORRANCE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90505-6130
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-530-8181
-----------------------------------------------------
Fax | 310-530-9221
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 25200 CRENSHAW BLVD SUITE 101
-----------------------------------------------------
City | TORRANCE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90505-6130
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-530-8181
-----------------------------------------------------
Fax | 310-530-9221
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/CEO
-----------------------------------------------------
Name | DR. KARA SHEA NANIA
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 310-530-8181
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | DC28520
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------