Provider Demographics
NPI:1164719654
Name:BOBBI JONES DC CHIROPRACTIC INC
Entity Type:Organization
Organization Name:BOBBI JONES DC CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BOBBI
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:323-308-8250
Mailing Address - Street 1:152 S SYCAMORE AVE APT 506
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-2934
Mailing Address - Country:US
Mailing Address - Phone:323-308-8250
Mailing Address - Fax:323-308-8250
Practice Address - Street 1:3037 W SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-2129
Practice Address - Country:US
Practice Address - Phone:323-308-8250
Practice Address - Fax:323-308-8250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-05
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29770111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEJ657ZMedicare PIN