Provider Demographics
NPI:1689730160
Name:BIG STONE LLC
Entity Type:Organization
Organization Name:BIG STONE LLC
Other - Org Name:CAL-CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:S
Authorized Official - Last Name:HIGASHI
Authorized Official - Suffix:
Authorized Official - Credentials:D C
Authorized Official - Phone:714-484-1280
Mailing Address - Street 1:1125 N MAGNOLIA AVE
Mailing Address - Street 2:SUITE 115
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-2638
Mailing Address - Country:US
Mailing Address - Phone:714-484-1280
Mailing Address - Fax:714-484-1358
Practice Address - Street 1:1125 N MAGNOLIA AVE
Practice Address - Street 2:SUITE 115
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-2638
Practice Address - Country:US
Practice Address - Phone:714-484-1280
Practice Address - Fax:714-484-1358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26404111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty