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General NPI Number Information
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NPI Number | 1659800886
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Entity Type | Individual
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Provider Name | AJ LABABIDI DC
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Gender | Male
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Dates
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Enumeration Date | 06/10/2017
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Last Update Date | 06/10/2017
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Provider Practice Location Address
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Address Line | 3560 GRAND AVE STE M
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City | CHINO HILLS
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State | CA
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Zip | 91709-5406
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Country | US
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Telephone | 909-315-3626
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Fax |
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Provider Business Mailing Address
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Address Line | 15680 HIGH KNOLL DR UNIT 217
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City | CHINO HILLS
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State | CA
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Zip | 91709-3899
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Country | US
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Telephone | 714-655-6238
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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 | 33878
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License Number State | CA
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