Provider Demographics
NPI:1144382243
Name:SUAREZ, JAVIER V (DC)
Entity Type:Individual
Prefix:DR
First Name:JAVIER
Middle Name:V
Last Name:SUAREZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 S BUENA VISTA ST
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4503
Mailing Address - Country:US
Mailing Address - Phone:818-563-2557
Mailing Address - Fax:818-563-1606
Practice Address - Street 1:114 S BUENA VISTA ST
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4503
Practice Address - Country:US
Practice Address - Phone:818-563-2557
Practice Address - Fax:818-563-1606
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19621111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC19621Medicare PIN
CAT87336Medicare UPIN