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General NPI Number Information
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NPI Number | 1881968907
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Entity Type | Organization
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Legal Business Name | AV PACIFIC MEDICAL MANAGEMENT INC
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Dates
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Enumeration Date | 03/07/2012
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Last Update Date | 03/07/2012
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Provider Practice Location Address
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Address Line | 1405 W RANCHO VISTA BLVD
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City | PALMDALE
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State | CA
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Zip | 93551-3968
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Country | US
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Telephone | 661-274-2014
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Fax |
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Provider Business Mailing Address
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Address Line | 1405 W RANCHO VISTA BLVD
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City | PALMDALE
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State | CA
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Zip | 93551-3968
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CORPORATE OFFICER
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Name | MR. LUIGI KIRCHMANN
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Credential |
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Telephone | 661-274-2014
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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 |
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License Number State |
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