Provider Demographics
NPI:1356081905
Name:DELGADO, LILIANN (DC)
Entity Type:Individual
Prefix:
First Name:LILIANN
Middle Name:
Last Name:DELGADO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 W VALLEY BLVD
Mailing Address - Street 2:#A2
Mailing Address - City:BIG BEAR
Mailing Address - State:CA
Mailing Address - Zip Code:92314
Mailing Address - Country:US
Mailing Address - Phone:909-584-7131
Mailing Address - Fax:
Practice Address - Street 1:501 W VALLEY BLVD
Practice Address - Street 2:#A2
Practice Address - City:BIG BEAR
Practice Address - State:CA
Practice Address - Zip Code:92314
Practice Address - Country:US
Practice Address - Phone:909-584-7131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-31
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32275111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor