Provider Demographics
NPI:1427497973
Name:SOUTH PASADENA CHIROPRACTIC WELLNESS CENTER
Entity type:Organization
Organization Name:SOUTH PASADENA CHIROPRACTIC WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:323-344-1423
Mailing Address - Street 1:1260 HUNTINGTON DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91030-4561
Mailing Address - Country:US
Mailing Address - Phone:323-344-1423
Mailing Address - Fax:323-344-1424
Practice Address - Street 1:1260 HUNTINGTON DR STE 101
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91030-4561
Practice Address - Country:US
Practice Address - Phone:323-344-1423
Practice Address - Fax:323-344-1424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC31092111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty