Provider Demographics
NPI:1063473528
Name:DONOHOE CHIROPRACTIC INC
Entity Type:Organization
Organization Name:DONOHOE CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:DONOHOE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:951-677-6500
Mailing Address - Street 1:41880 KALMIA ST STE 135
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562
Mailing Address - Country:US
Mailing Address - Phone:951-677-6500
Mailing Address - Fax:951-677-2665
Practice Address - Street 1:41880 KALMIA ST STE 135
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562
Practice Address - Country:US
Practice Address - Phone:951-677-6500
Practice Address - Fax:951-677-2665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-31
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26378111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU75506Medicare UPIN
CADC0263780Medicare ID - Type Unspecified