Provider Demographics
NPI:1649571365
Name:ROBINSON R. LANGILLE CHIROPRACTIC CORP.
Entity Type:Organization
Organization Name:ROBINSON R. LANGILLE CHIROPRACTIC CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBINSON
Authorized Official - Middle Name:REED
Authorized Official - Last Name:LANGILLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:415-971-4816
Mailing Address - Street 1:4155 EXECUTIVE DR
Mailing Address - Street 2:SUITE E401
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1351
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1010 UNIVERSITY AVE
Practice Address - Street 2:SUITE C-201
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-3398
Practice Address - Country:US
Practice Address - Phone:619-992-5933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-11
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30232111NR0400X, 111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0100XChiropractic ProvidersChiropractorOccupational HealthGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty