NPI Code Detail JSON Logo

1730339318 NPI number — MANUEL CANABAL L.AC.

NPI Number: 1730339318
Health Care Provider/Practitioner: MANUEL CANABAL L.AC.

Information about “1730339318” NPI (MANUEL CANABAL L.AC.) exists in 1730339318 in HTML format HTML  |  1730339318 in plain Text format TXT  |  1730339318 in PDF (Portable Document Format) PDF  |  1730339318 in an XML format XML  formats.

NPI Number : 1730339318 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1730339318",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CANABAL",
    "FirstName": "MANUEL",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "L.AC.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "634 SHELDON ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "EL SEGUNDO",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "90245-3035",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "310-647-1979",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "9612 VAN NUYS BLVD",
    "SecondLinePracticeLocationAddress": "SUITE 101",
    "PracticeLocationAddressCityName": "PANORAMA CITY",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "91402-1044",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "818-830-5050",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/19/2008",
    "LastUpdateDate": "01/26/2011",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "171100000X",
        "TaxonomyName": "Acupuncturist",
        "LicenseNumber": "AC 12605",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2025 Data Labs Health. All rights reserved.