Provider Demographics
NPI:1154591170
Name:LUIS ARRIAZA CHIROPRACTIC, INC
Entity type:Organization
Organization Name:LUIS ARRIAZA CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:EVELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARRIAZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-945-9190
Mailing Address - Street 1:14330 RAMONA BLVD
Mailing Address - Street 2:
Mailing Address - City:BALDWIN PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91706-3241
Mailing Address - Country:US
Mailing Address - Phone:626-960-2346
Mailing Address - Fax:626-960-0549
Practice Address - Street 1:14330 RAMONA BLVD
Practice Address - Street 2:
Practice Address - City:BALDWIN PARK
Practice Address - State:CA
Practice Address - Zip Code:91706-3241
Practice Address - Country:US
Practice Address - Phone:626-960-2346
Practice Address - Fax:626-960-0549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23197111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1295922839OtherNPI TYPE 1