Provider Demographics
NPI:1093878274
Name:BYBYK CHIROPRACTIC INC
Entity Type:Organization
Organization Name:BYBYK CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:BYBYK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:951-677-7343
Mailing Address - Street 1:24663 MONROE AVE.
Mailing Address - Street 2:SUITE #101
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562
Mailing Address - Country:US
Mailing Address - Phone:951-677-7343
Mailing Address - Fax:951-677-7163
Practice Address - Street 1:24663 MONROE AVE.
Practice Address - Street 2:SUITE #101
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562
Practice Address - Country:US
Practice Address - Phone:951-677-7343
Practice Address - Fax:951-677-7163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC21914111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0219140OtherBLUE SHIELD
CADC0219140Medicare ID - Type Unspecified
CAZZZ06964ZMedicare PIN