Provider Demographics
NPI:1346426319
Name:LOS QUIROPRACTICOS, LLC
Entity Type:Organization
Organization Name:LOS QUIROPRACTICOS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOAR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:805-487-4043
Mailing Address - Street 1:PO BOX 5603
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93031-5603
Mailing Address - Country:US
Mailing Address - Phone:805-487-4043
Mailing Address - Fax:805-487-4003
Practice Address - Street 1:300 S MCLEAN BLVD STE N
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-1023
Practice Address - Country:US
Practice Address - Phone:847-697-1234
Practice Address - Fax:847-697-8205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-21
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILDC24189111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty