MEDICARE: THE LAUDIG CHIROPRACTIC CENTER PC

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
1	111N00000X	Chiropractor	DC28810	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235279241
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE LAUDIG CHIROPRACTIC CENTER PC

Provider Business Mailing Address
First Line	:	2170 LOMITA BLVD
Second Line	:
City	:	LOMITA
State	:	CA
Zip	:	90717-1623
Country	:	US
Telephone Number	:	310-530-1659
Fax Number	:	310-530-1663

Provider Business Practice Location Address
First Line	:	2170 LOMITA BLVD
Second Line	:
City	:	LOMITA
State	:	CA
Zip	:	90717-1623
Country	:	US
Telephone Number	:	310-530-1659
Fax Number	:	310-530-1663

Authorized Official
Title or Position	:	OWNER PRESIDENT
Name	:	DR. MARTY JO LAUDIG
Credential	:	D.C.
Telephone Number	:	310-530-1659

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	08/22/2020

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