Provider Demographics
NPI:1093941387
Name:PCH CHIRO INC.
Entity Type:Organization
Organization Name:PCH CHIRO INC.
Other - Org Name:ADAM LEE SANDAHL, DC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWN/DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:L
Authorized Official - Last Name:SANDAHL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:562-430-8501
Mailing Address - Street 1:6557 E. PCH H-10
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-4202
Mailing Address - Country:US
Mailing Address - Phone:562-430-8501
Mailing Address - Fax:562-430-8591
Practice Address - Street 1:6557 E. PCH H-10
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90803-4202
Practice Address - Country:US
Practice Address - Phone:562-430-8501
Practice Address - Fax:562-430-8591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-01
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24587111N00000X
CA24587111NR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NR0200XChiropractic ProvidersChiropractorRadiologyGroup - Multi-Specialty