Provider Demographics
NPI:1114230216
Name:SANTANA INJURY CENTER
Entity Type:Organization
Organization Name:SANTANA INJURY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RUBEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTANA
Authorized Official - Suffix:
Authorized Official - Credentials:DC,
Authorized Official - Phone:562-691-4900
Mailing Address - Street 1:860 E LA HABRA BLVD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-5532
Mailing Address - Country:US
Mailing Address - Phone:562-691-4900
Mailing Address - Fax:562-691-4300
Practice Address - Street 1:860 E LA HABRA BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-5532
Practice Address - Country:US
Practice Address - Phone:562-691-4900
Practice Address - Fax:562-691-4300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-16
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27759111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty