Provider Demographics
NPI:1386172757
Name:JOSHUA AND JACOB PAREDES CHIROPRACTIC CORP
Entity type:Organization
Organization Name:JOSHUA AND JACOB PAREDES CHIROPRACTIC CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:PAREDES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:714-585-2937
Mailing Address - Street 1:600 PACIFIC COAST HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-6600
Mailing Address - Country:US
Mailing Address - Phone:714-585-2937
Mailing Address - Fax:
Practice Address - Street 1:600 PACIFIC COAST HWY STE 200
Practice Address - Street 2:
Practice Address - City:SEAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:90740
Practice Address - Country:US
Practice Address - Phone:714-585-2937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33320111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty