Provider Demographics
NPI:1285802553
Name:MURILLO, CORAZON (DC)
Entity type:Individual
Prefix:DR
First Name:CORAZON
Middle Name:
Last Name:MURILLO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:CORAZON
Other - Middle Name:
Other - Last Name:MURILLO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:10801 FOOTHILL BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-7694
Mailing Address - Country:US
Mailing Address - Phone:909-989-4435
Mailing Address - Fax:909-989-4461
Practice Address - Street 1:10801 FOOTHILL BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-7694
Practice Address - Country:US
Practice Address - Phone:909-989-4435
Practice Address - Fax:909-989-4461
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-20
Last Update Date:2013-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23557111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor