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General NPI Number Information
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NPI Number | 1740593128
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Entity Type | Organization
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Legal Business Name | GAGE CHIROPRACTIC
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Dates
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Enumeration Date | 07/14/2010
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Last Update Date | 07/14/2010
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Provider Practice Location Address
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Address Line | 2701 E GAGE AVE STE 102
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City | HUNTINGTON PARK
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State | CA
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Zip | 90255-5491
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Country | US
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Telephone | 323-588-7070
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Fax | 323-588-7073
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Provider Business Mailing Address
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Address Line | 2701 E GAGE AVE STE 102
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City | HUNTINGTON PARK
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State | CA
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Zip | 90255-5491
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Country | US
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Telephone | 323-588-7070
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Fax | 323-588-7073
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Authorized Official
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Title or Position | CEO
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Name | MOHSEN BAHRI
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Credential | D.C
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Telephone | 323-588-7070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State |
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