Provider Demographics
NPI:1497872006
Name:JOHN P. FILIPPINI CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:JOHN P. FILIPPINI CHIROPRACTIC CORPORATION
Other - Org Name:STONE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTIC ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:GERRY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:FILIPPINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-823-1163
Mailing Address - Street 1:1497 W YOSEMITE AVE
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95337-5100
Mailing Address - Country:US
Mailing Address - Phone:209-823-1163
Mailing Address - Fax:209-823-8209
Practice Address - Street 1:1497 W YOSEMITE AVE
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95337-5100
Practice Address - Country:US
Practice Address - Phone:209-823-1163
Practice Address - Fax:209-823-8209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19115111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA19115OtherCHIROPRACTIC LICENSE
CADC0191150Medicare ID - Type Unspecified
CA19115OtherCHIROPRACTIC LICENSE