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General NPI Number Information
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NPI Number | 1891020954
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Entity Type | Organization
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Legal Business Name | WHITELEY CHIROPRACTIC CENTER, INC.
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Dates
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Enumeration Date | 10/07/2009
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Last Update Date | 08/09/2012
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Provider Practice Location Address
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Address Line | 1042 W EL NORTE PKWY
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City | ESCONDIDO
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State | CA
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Zip | 92026-3341
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Country | US
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Telephone | 760-480-7555
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Fax | 760-480-7593
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Provider Business Mailing Address
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Address Line | 1042 W EL NORTE PKWY
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City | ESCONDIDO
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State | CA
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Zip | 92026-3341
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Country | US
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Telephone | 760-480-7555
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Fax | 760-480-7593
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Authorized Official
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Title or Position | PRESIDENT/TREASURER
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Name | DR. PETER RANDOLPH WHITELEY
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Credential | D.C.
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Telephone | 760-480-7555
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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 | DC25536
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License Number State | CA
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