Provider Demographics
NPI:1104153691
Name:FARRELL, ELIZABETH MCEACHERN (DC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MCEACHERN
Last Name:FARRELL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:MCEACHERN
Other - Last Name:STEVENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 90256
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92169-2256
Mailing Address - Country:US
Mailing Address - Phone:858-410-0049
Mailing Address - Fax:
Practice Address - Street 1:4645 CASS ST
Practice Address - Street 2:# 201C
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-2846
Practice Address - Country:US
Practice Address - Phone:858-410-0049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-04
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32488111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor