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General NPI Number Information
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NPI Number | 1649572777
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Entity Type | Organization
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Legal Business Name | MERLO CHIROPRACTIC, INC
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Dates
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Enumeration Date | 11/22/2010
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Last Update Date | 11/22/2010
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Provider Practice Location Address
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Address Line | 4060 ADAMS AVE
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City | SAN DIEGO
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State | CA
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Zip | 92116-2504
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Country | US
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Telephone | 619-281-1234
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Fax |
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Provider Business Mailing Address
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Address Line | 4060 ADAMS AVE
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City | SAN DIEGO
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State | CA
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Zip | 92116-2504
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Country | US
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Telephone | 619-281-1234
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOSEPH A MERLO
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Credential | D.C.
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Telephone | 619-281-1234
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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 | 29916
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License Number State | CA
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