Provider Demographics
NPI:1376711903
Name:JULIO CARDONA JR., P.C.
Entity Type:Organization
Organization Name:JULIO CARDONA JR., P.C.
Other - Org Name:CARDONA CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:CESAR
Authorized Official - Last Name:CARDONA
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:760-716-5373
Mailing Address - Street 1:14335 SW ALLEN BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-4463
Mailing Address - Country:US
Mailing Address - Phone:503-352-0265
Mailing Address - Fax:503-601-0543
Practice Address - Street 1:14335 SW ALLEN BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-4463
Practice Address - Country:US
Practice Address - Phone:503-352-0265
Practice Address - Fax:503-601-0543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-18
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR713673111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty