Provider Demographics
NPI:1316044688
Name:ANTHONYS CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:ANTHONYS CHIROPRACTIC INC.
Other - Org Name:ANTHONY'S CHIROPRACTOR HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTHONY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:310-673-1700
Mailing Address - Street 1:4859 W SLAUSON AVE
Mailing Address - Street 2:228
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90056-1290
Mailing Address - Country:US
Mailing Address - Phone:310-673-1700
Mailing Address - Fax:
Practice Address - Street 1:4859 W SLAUSON AVE
Practice Address - Street 2:228
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90056-1290
Practice Address - Country:US
Practice Address - Phone:310-673-1700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW16445Medicare UPIN