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NPI Code Detail

MEDICARE: PAV CHINCHILLA D.C.

MEDICARE: PAV CHINCHILLA D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorDC27865CA

General Provider Information

NPI Number : 1003920067
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAV CHINCHILLA D.C.
Provider Business Mailing Address
First Line : 6456 YORK BLVD
Second Line :
City : HIGHLAND PARK
State : CA
Zip : 90042-3642
Country : US
Telephone Number : 800-775-7787
Fax Number :
Provider Business Practice Location Address
First Line : 6456 YORK BLVD
Second Line :
City : HIGHLAND PARK
State : CA
Zip : 90042-3642
Country : US
Telephone Number : 800-775-7787
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2006
Last Update Date : 07/08/2007

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Directions to “ PAV CHINCHILLA D.C.” Practice Location

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