Provider Demographics
NPI:1689158289
Name:PRECIADO, MARIA G (CHIROPRACTOR)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:G
Last Name:PRECIADO
Suffix:
Gender:F
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:G
Other - Last Name:VILLEGAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3821 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90063-3601
Mailing Address - Country:US
Mailing Address - Phone:323-263-0075
Mailing Address - Fax:323-263-0481
Practice Address - Street 1:3821 E 1ST ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90063-3601
Practice Address - Country:US
Practice Address - Phone:323-263-0075
Practice Address - Fax:323-263-0481
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23952111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty