Provider Demographics
NPI:1689068090
Name:ELKHIAR CHIROPRACTIC CENTERS, INC., A CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:ELKHIAR CHIROPRACTIC CENTERS, INC., A CHIROPRACTIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELMOSTFA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELKHIAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-988-2554
Mailing Address - Street 1:229 N LAUREL AVE
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-3500
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3165 N GAREY AVE
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-1366
Practice Address - Country:US
Practice Address - Phone:909-392-2230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-24
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0100XChiropractic ProvidersChiropractorOccupational HealthGroup - Single Specialty