Provider Demographics
NPI:1043383052
Name:GIRALDO, DORIS D (DC, LAC)
Entity Type:Individual
Prefix:DR
First Name:DORIS
Middle Name:D
Last Name:GIRALDO
Suffix:
Gender:F
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18141 BEACH BLVD
Mailing Address - Street 2:STE 320
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-5696
Mailing Address - Country:US
Mailing Address - Phone:714-375-0313
Mailing Address - Fax:714-375-8913
Practice Address - Street 1:18141 BEACH BLVD
Practice Address - Street 2:STE 320
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-5696
Practice Address - Country:US
Practice Address - Phone:714-375-0313
Practice Address - Fax:714-375-8913
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24716111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU79194Medicare UPIN