Provider Demographics
NPI:1366565285
Name:LIBS CHIROPRACTIC CENTER, INC.
Entity type:Organization
Organization Name:LIBS CHIROPRACTIC CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:E
Authorized Official - Last Name:LIBS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:858-483-8500
Mailing Address - Street 1:4410 LAMONT ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-4515
Mailing Address - Country:US
Mailing Address - Phone:858-483-8500
Mailing Address - Fax:858-272-0054
Practice Address - Street 1:4410 LAMONT ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-4515
Practice Address - Country:US
Practice Address - Phone:858-483-8500
Practice Address - Fax:858-272-0054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-07
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1366565285Medicare PIN