Provider Demographics
NPI:1578626867
Name:FALKENROTH, ESTRELLA (DC)
Entity Type:Individual
Prefix:DR
First Name:ESTRELLA
Middle Name:
Last Name:FALKENROTH
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 1:11022 WINNERS CIR
Mailing Address - Street 2:SUITE 107
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-2832
Mailing Address - Country:US
Mailing Address - Phone:562-430-9479
Mailing Address - Fax:562-430-9473
Practice Address - Street 1:2959 PARK AVE
Practice Address - Street 2:SUITE F
Practice Address - City:SOQUEL
Practice Address - State:CA
Practice Address - Zip Code:95073-2863
Practice Address - Country:US
Practice Address - Phone:831-475-8600
Practice Address - Fax:831-475-8601
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACADC25945111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0259450Medicare ID - Type Unspecified