Provider Demographics
NPI:1184835902
Name:ATLANTIC PHYSICAL REHAB CENTER, CAVE & BELTRAN CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:ATLANTIC PHYSICAL REHAB CENTER, CAVE & BELTRAN CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:DR
Authorized Official - First Name:AGATHA
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:BELTRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:562-988-3626
Mailing Address - Street 1:2530 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-2741
Mailing Address - Country:US
Mailing Address - Phone:562-988-3626
Mailing Address - Fax:
Practice Address - Street 1:2530 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2741
Practice Address - Country:US
Practice Address - Phone:562-988-3626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29613111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty