Provider Demographics
NPI:1639298557
Name:RANDY S. HIGASHI CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:RANDY S. HIGASHI CHIROPRACTIC, INC.
Other - Org Name:ANAHEIM HEALTH CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:SHANE
Authorized Official - Last Name:HIGASHI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:323-546-3500
Mailing Address - Street 1:13502 WHITTER BLVD.
Mailing Address - Street 2:SUITE H, #507
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-1944
Mailing Address - Country:US
Mailing Address - Phone:323-546-3500
Mailing Address - Fax:323-638-1253
Practice Address - Street 1:3621 MARTIN LUTHER KING JR. BLVD.
Practice Address - Street 2:SUITE # 14
Practice Address - City:LYNWOOD
Practice Address - State:CA
Practice Address - Zip Code:90262-3512
Practice Address - Country:US
Practice Address - Phone:323-546-3500
Practice Address - Fax:323-638-1253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA111N00000X
CADC26404111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty