Provider Demographics
NPI:1326156829
Name:RICH AND JANNELLI CHIROPRACTIC CORPORTATION
Entity Type:Organization
Organization Name:RICH AND JANNELLI CHIROPRACTIC CORPORTATION
Other - Org Name:ELITE CARE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDIENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:RICH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:760-634-3701
Mailing Address - Street 1:191 N EL CAMINO REAL
Mailing Address - Street 2:STE 205
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-5362
Mailing Address - Country:US
Mailing Address - Phone:760-634-3701
Mailing Address - Fax:760-632-9468
Practice Address - Street 1:191 N EL CAMINO REAL
Practice Address - Street 2:STE 205
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5362
Practice Address - Country:US
Practice Address - Phone:760-634-3701
Practice Address - Fax:760-632-9468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-26
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23357111N00000X
CADC22913111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty