Provider Demographics
NPI:1609172949
Name:KALRA CHIROPRACTIC INC
Entity Type:Organization
Organization Name:KALRA CHIROPRACTIC INC
Other - Org Name:OPTIMUM ENTERPRISES INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CHIROPRACTOR/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:KALRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-831-1447
Mailing Address - Street 1:639 W 9TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90731
Mailing Address - Country:US
Mailing Address - Phone:310-831-1447
Mailing Address - Fax:310-831-5728
Practice Address - Street 1:639 W 9TH ST
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90731
Practice Address - Country:US
Practice Address - Phone:310-831-1447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-03
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-27928111N00000X
AC11228171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty