Provider Demographics
NPI:1073602009
Name:GENE ORLOWSKY, D.C. INC A CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:GENE ORLOWSKY, D.C. INC A CHIROPRACTIC CORPORATION
Other - Org Name:GEO CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GENE
Authorized Official - Middle Name:
Authorized Official - Last Name:ORLOWSKY
Authorized Official - Suffix:
Authorized Official - Credentials:CHIROPRACTOR
Authorized Official - Phone:626-441-2264
Mailing Address - Street 1:2646 MISSION ST
Mailing Address - Street 2:
Mailing Address - City:SAN MARINO
Mailing Address - State:CA
Mailing Address - Zip Code:91108-1638
Mailing Address - Country:US
Mailing Address - Phone:626-441-2264
Mailing Address - Fax:626-441-3533
Practice Address - Street 1:2646 MISSION ST
Practice Address - Street 2:
Practice Address - City:SAN MARINO
Practice Address - State:CA
Practice Address - Zip Code:91108-1638
Practice Address - Country:US
Practice Address - Phone:626-441-2264
Practice Address - Fax:626-441-3533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2018-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC14181111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWDC9305Medicare ID - Type Unspecified