Provider Demographics
NPI:1073238697
Name:HIGASHI CHIROPRACTIC INCORPORATED
Entity Type:Organization
Organization Name:HIGASHI CHIROPRACTIC INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:S
Authorized Official - Last Name:HIGASHI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:562-587-8577
Mailing Address - Street 1:3621 MARTIN LUTHER KING JR BLVD STE 14
Mailing Address - Street 2:
Mailing Address - City:LYNWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90262-3512
Mailing Address - Country:US
Mailing Address - Phone:562-587-8577
Mailing Address - Fax:
Practice Address - Street 1:3621 MARTIN LUTHER KING JR BLVD STE 14
Practice Address - Street 2:
Practice Address - City:LYNWOOD
Practice Address - State:CA
Practice Address - Zip Code:90262-3512
Practice Address - Country:US
Practice Address - Phone:424-403-4090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0100XChiropractic ProvidersChiropractorOccupational HealthGroup - Single Specialty