Provider Demographics
NPI:1043393101
Name:KOROL, ADRIAN JULIAN (DC)
Entity Type:Individual
Prefix:DR
First Name:ADRIAN
Middle Name:JULIAN
Last Name:KOROL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 S PACIFIC COAST HIGHWAY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277
Mailing Address - Country:US
Mailing Address - Phone:310-374-7482
Mailing Address - Fax:310-372-2932
Practice Address - Street 1:234 S PACIFIC COAST HIGHWAY
Practice Address - Street 2:SUITE 202
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277
Practice Address - Country:US
Practice Address - Phone:310-374-7482
Practice Address - Fax:310-372-2932
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC13819111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T17615Medicare UPIN