Provider Demographics
NPI:1528258233
Name:FLETCHER HILLS CHIROPRACTIC CLINIC
Entity type:Organization
Organization Name:FLETCHER HILLS CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FLOYD
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:ENGLANT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:619-464-6781
Mailing Address - Street 1:566 HOSMER ST
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-2740
Mailing Address - Country:US
Mailing Address - Phone:619-464-6781
Mailing Address - Fax:619-464-6873
Practice Address - Street 1:566 HOSMER ST
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-2740
Practice Address - Country:US
Practice Address - Phone:619-464-6781
Practice Address - Fax:619-464-6873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11898111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT04542Medicare UPIN
CAT04337Medicare UPIN