Provider Demographics
NPI:1043392509
Name:CORTES-RING CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:CORTES-RING CHIROPRACTIC, INC.
Other - Org Name:LA MESA SPINE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:RING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:619-464-1600
Mailing Address - Street 1:7441 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-6004
Mailing Address - Country:US
Mailing Address - Phone:619-464-1600
Mailing Address - Fax:619-464-6546
Practice Address - Street 1:7441 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-6004
Practice Address - Country:US
Practice Address - Phone:619-464-1600
Practice Address - Fax:619-464-6546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28156111N00000X
CADC-28938111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
W17935OtherMEDICARE PTAN
CAWDC28156AMedicare ID - Type Unspecified
CA6189990001Medicare NSC
CAY16764Medicare UPIN
W17935OtherMEDICARE PTAN