Provider Demographics
NPI:1316696800
Name:CONTRERAS, ANTHONY STEVEN (DC)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:STEVEN
Last Name:CONTRERAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4425 ATLANTIC AVE STE A10
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-2245
Mailing Address - Country:US
Mailing Address - Phone:562-743-7428
Mailing Address - Fax:
Practice Address - Street 1:4425 ATLANTIC AVE STE A10
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-2245
Practice Address - Country:US
Practice Address - Phone:562-743-7428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36312111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor