Provider Demographics
NPI:1083002745
Name:PACIFIC WELLNESS CENTER CHIROPRACTIC, ISEKE BELTRAN INC
Entity Type:Organization
Organization Name:PACIFIC WELLNESS CENTER CHIROPRACTIC, ISEKE BELTRAN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:
Authorized Official - Last Name:ISEKE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:562-426-2244
Mailing Address - Street 1:3711 LONG BEACH BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-3315
Mailing Address - Country:US
Mailing Address - Phone:562-426-2244
Mailing Address - Fax:
Practice Address - Street 1:3711 LONG BEACH BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-3315
Practice Address - Country:US
Practice Address - Phone:562-426-2244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-05
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty