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NPI 1942258447

NPI 1942258447 : ISAAC MERINO D.C. : LAWNDALE, CA

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General NPI Number Information
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    NPI Number           |    1942258447
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    Entity Type          |    Individual 
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    Provider Name        |    ISAAC MERINO D.C.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/05/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    3940 MARINE AVE SUITE I
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    City                 |    LAWNDALE
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    State                |    CA
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    Zip                  |    90260-2333
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    Country              |    US
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    Telephone            |    310-679-7146
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    Fax                  |    310-679-7022
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Provider Business Mailing Address
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    Address Line         |    PO BOX 120 
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    City                 |    HAWTHORNE
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    State                |    CA
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    Zip                  |    90251-0120
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    Country              |    US
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    Telephone            |    310-679-7146
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    Fax                  |    310-679-7022
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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       |    27939
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    License Number State |    CA
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