Provider Demographics
NPI:1992719553
Name:CLARENCE HUNTER CHIROPRACTIC INC
Entity type:Organization
Organization Name:CLARENCE HUNTER CHIROPRACTIC INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CLARENCE
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:323-791-2598
Mailing Address - Street 1:2437 HARWOOD ST
Mailing Address - Street 2:1222 E. COLORADO BLVD
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-1239
Mailing Address - Country:US
Mailing Address - Phone:323-791-2598
Mailing Address - Fax:626-578-9718
Practice Address - Street 1:1222 E COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-1842
Practice Address - Country:US
Practice Address - Phone:323-791-2598
Practice Address - Fax:626-578-9718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 28679111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty