Provider Demographics
NPI:1629320452
Name:MORALES CHIROPRACTIC-ORTHOPEDIC CARE
Entity Type:Organization
Organization Name:MORALES CHIROPRACTIC-ORTHOPEDIC CARE
Other - Org Name:MORALES CHIROPRACTIC CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:P
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:626-796-4141
Mailing Address - Street 1:935 E GREEN ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-2906
Mailing Address - Country:US
Mailing Address - Phone:626-796-4141
Mailing Address - Fax:
Practice Address - Street 1:935 E GREEN ST
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-2906
Practice Address - Country:US
Practice Address - Phone:626-796-4141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-03
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16644111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty