Provider Demographics
NPI:1093998049
Name:WRANGE, ASA (DC)
Entity Type:Individual
Prefix:
First Name:ASA
Middle Name:
Last Name:WRANGE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:292 S LA CIENEGA BLVD STE 400E
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3344
Mailing Address - Country:US
Mailing Address - Phone:310-360-1199
Mailing Address - Fax:310-360-1177
Practice Address - Street 1:292 S LA CIENEGA BLVD
Practice Address - Street 2:STE 400E
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3307
Practice Address - Country:US
Practice Address - Phone:310-360-1199
Practice Address - Fax:310-360-1177
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27968111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor