Provider Demographics
NPI:1336322841
Name:R. MARINARO CHIROPRACTIC CORP.
Entity Type:Organization
Organization Name:R. MARINARO CHIROPRACTIC CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:MARINARO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:818-505-0816
Mailing Address - Street 1:12215 VENTURA BLVD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-2533
Mailing Address - Country:US
Mailing Address - Phone:818-505-0816
Mailing Address - Fax:818-505-8623
Practice Address - Street 1:12215 VENTURA BLVD
Practice Address - Street 2:SUITE 208
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-2533
Practice Address - Country:US
Practice Address - Phone:818-505-0816
Practice Address - Fax:818-505-8623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-07
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC16717111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW20779Medicare PIN