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NPI Code Detail

MEDICARE: DR. THERESA ANN FITZGERALD D.C.

MEDICARE: DR. THERESA ANN FITZGERALD 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
1111N00000XChiropractor20181CA

General Provider Information

NPI Number : 1952314759
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THERESA ANN FITZGERALD D.C.
Provider Business Mailing Address
First Line : 2904 ROWENA AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90039-2042
Country : US
Telephone Number : 323-660-2370
Fax Number : 323-663-4100
Provider Business Practice Location Address
First Line : 2904 ROWENA AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90039-2042
Country : US
Telephone Number : 323-660-2370
Fax Number : 323-663-4100
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2006
Last Update Date : 11/13/2014

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