Provider Demographics
NPI:1609123983
Name:LIDIA ALZATE DC A CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:LIDIA ALZATE DC A CHIROPRACTIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LIDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALZATE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:818-842-7700
Mailing Address - Street 1:916 W BURBANK BLVD
Mailing Address - Street 2:SUITE L
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-1400
Mailing Address - Country:US
Mailing Address - Phone:818-842-7700
Mailing Address - Fax:
Practice Address - Street 1:916 W BURBANK BLVD
Practice Address - Street 2:SUITE L
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-1400
Practice Address - Country:US
Practice Address - Phone:818-842-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32309111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1720348758OtherINDIVIDUAL NATIONAL PROVIDER IDENTIFICATION NUMBER