Provider Demographics
NPI:1265678676
Name:NUNEZ CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:NUNEZ CHIROPRACTIC, INC.
Other - Org Name:ALAN J NUNEZ, D.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:NUNEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:818-247-4411
Mailing Address - Street 1:200 N MARYLAND AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-4262
Mailing Address - Country:US
Mailing Address - Phone:818-247-4411
Mailing Address - Fax:
Practice Address - Street 1:200 N MARYLAND AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4262
Practice Address - Country:US
Practice Address - Phone:818-247-4411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-06
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC15338111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1609861236Medicare PIN
CAT18041 CAMedicare UPIN