Provider Demographics
NPI:1194960880
Name:DE SESA CHIROPRACTIC INC.
Entity type:Organization
Organization Name:DE SESA CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:DE SESA
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:661-294-0429
Mailing Address - Street 1:27674 NEWHALL RANCH RD
Mailing Address - Street 2:SUITE 65
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-4018
Mailing Address - Country:US
Mailing Address - Phone:661-294-0429
Mailing Address - Fax:
Practice Address - Street 1:27674 NEWHALL RANCH RD
Practice Address - Street 2:SUITE 65
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-4018
Practice Address - Country:US
Practice Address - Phone:661-294-0429
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25850261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service