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NPI Code Detail

MEDICARE: CARLOS RODRIGUEZ CHIROPRACTIC, INC

MEDICARE: CARLOS RODRIGUEZ CHIROPRACTIC, INC
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
1111N00000XChiropractorDC27849CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2W18633OTHERCAMEDICARE GRP #

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11093879583OTHERCATYPE 1 NPI #

General Provider Information

NPI Number : 1689843187
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARLOS RODRIGUEZ CHIROPRACTIC, INC
Provider Business Mailing Address
First Line : 1511 4TH ST
Second Line :
City : SANTA MONICA
State : CA
Zip : 90401-2310
Country : US
Telephone Number : 310-899-1166
Fax Number : 310-899-1009
Provider Business Practice Location Address
First Line : 1511 4TH ST
Second Line :
City : SANTA MONICA
State : CA
Zip : 90401-2310
Country : US
Telephone Number : 310-899-1166
Fax Number : 310-899-1009
Authorized Official
Title or Position : OWNER/PRESIDENT
Name : DR. CARLOS CELSO RODRIGUEZ
Credential : D.C.
Telephone Number : 310-899-1166
Provider Enumeration Date : 02/28/2008
Last Update Date : 02/28/2008

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Directions to “CARLOS RODRIGUEZ CHIROPRACTIC, INC ” Practice Location

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