Provider Demographics
NPI:1659882934
Name:PEREZ CHIROPRACTIC
Entity Type:Organization
Organization Name:PEREZ CHIROPRACTIC
Other - Org Name:PEREZ CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSANNA
Authorized Official - Middle Name:R
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:760-690-2227
Mailing Address - Street 1:2065 S ESCONDIDO BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-8221
Mailing Address - Country:US
Mailing Address - Phone:760-565-2225
Mailing Address - Fax:760-690-2212
Practice Address - Street 1:2065 S ESCONDIDO BLVD STE 105
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-8221
Practice Address - Country:US
Practice Address - Phone:760-565-2225
Practice Address - Fax:760-690-2212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-13
Last Update Date:2017-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-30815111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty