Provider Demographics
NPI:1275606402
Name:LOJACONO, JOSEPH GARY (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:GARY
Last Name:LOJACONO
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 1:1830 SPRING ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446-1617
Mailing Address - Country:US
Mailing Address - Phone:805-226-8001
Mailing Address - Fax:
Practice Address - Street 1:1830 SPRING ST
Practice Address - Street 2:SUITE A
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-1617
Practice Address - Country:US
Practice Address - Phone:805-226-8001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC23300OtherBLUE CROSS
CADC023300OtherBLUE SHIELD
CAU51551Medicare UPIN
CAP00118762Medicare ID - Type UnspecifiedRAILROAD MEDICARE #
CADC23300OtherBLUE CROSS