Provider Demographics
NPI:1306971288
Name:HOLLAND CHIROPRACTIC INC.
Entity type:Organization
Organization Name:HOLLAND CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:HASKELL
Authorized Official - Last Name:HOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:562-694-8347
Mailing Address - Street 1:355 S HARBOR BLVD
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-5643
Mailing Address - Country:US
Mailing Address - Phone:562-694-8347
Mailing Address - Fax:
Practice Address - Street 1:355 S HARBOR BLVD
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-5643
Practice Address - Country:US
Practice Address - Phone:562-694-8347
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOLLAND CHIROPRACTIC INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-22
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19838261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW13060Medicare PIN