Provider Demographics
NPI:1558387563
Name:LA HOOD, NICHOLAS T (DC)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:T
Last Name:LA HOOD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9932 MERCY RD
Mailing Address - Street 2:UNIT 106
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129
Mailing Address - Country:US
Mailing Address - Phone:858-987-8282
Mailing Address - Fax:858-987-8383
Practice Address - Street 1:9932 MERCY RD
Practice Address - Street 2:UNIT 106
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92129
Practice Address - Country:US
Practice Address - Phone:858-987-8282
Practice Address - Fax:858-987-8383
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9185111N00000X
IL38009937111N00000X
CA31863111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB224850OtherMEDICARE PTAN