=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952545881
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LOY CHIROPRACTIC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/22/2009
-----------------------------------------------------
Last Update Date | 04/22/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1349 CAMINO DEL MAR SUITE F
-----------------------------------------------------
City | DEL MAR
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92014-2553
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 858-793-1104
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1349 CAMINO DEL MAR SUITE F
-----------------------------------------------------
City | DEL MAR
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92014-2553
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 858-793-1104
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIROPRACTOR
-----------------------------------------------------
Name | LAMONT STUART LOY
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 858-793-1104
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | DC18277
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------