Provider Demographics
NPI:1104079169
Name:PACINI, CARLOS ANDRES (DC)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:ANDRES
Last Name:PACINI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23622 CALABASAS RD STE 349
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-1594
Mailing Address - Country:US
Mailing Address - Phone:818-620-0154
Mailing Address - Fax:
Practice Address - Street 1:23622 CALABASAS RD STE 349
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-1594
Practice Address - Country:US
Practice Address - Phone:818-620-0154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24913111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor