Provider Demographics
NPI:1659400406
Name:DR LARRY HERRING PA
Entity Type:Organization
Organization Name:DR LARRY HERRING PA
Other - Org Name:HERRING CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HERRING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:858-674-7200
Mailing Address - Street 1:15817 BERNARDO CENTER DR STE 105
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-2322
Mailing Address - Country:US
Mailing Address - Phone:858-674-7200
Mailing Address - Fax:858-674-7277
Practice Address - Street 1:15817 BERNARDO CENTER DR STE 105
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-2322
Practice Address - Country:US
Practice Address - Phone:858-674-7200
Practice Address - Fax:858-674-7277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC17609111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherTAX ID #
CAT54835Medicare UPIN