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General NPI Number Information
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NPI Number | 1639332679
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Entity Type | Organization
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Legal Business Name | ALTAMIRANO CHIROPRACTIC
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Dates
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Enumeration Date | 07/09/2008
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Last Update Date | 03/11/2010
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Provider Practice Location Address
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Address Line | 601 N AVALON BLVD STE D
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City | WILMINGTON
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State | CA
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Zip | 90744-5807
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Country | US
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Telephone | 310-513-8059
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Fax | 310-513-9247
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Provider Business Mailing Address
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Address Line | 601 N AVALON BLVD STE D
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City | WILMINGTON
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State | CA
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Zip | 90744-5807
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Country | US
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Telephone | 310-513-8059
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Fax | 310-513-9247
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Authorized Official
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Title or Position | OWNER
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Name | SEBASTIAN A ALTAMIRANO
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Credential | D.C.
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Telephone | 31051380529
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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