Provider Demographics
NPI:1689907099
Name:ROSENFELD CHIROPRACTIC CORP
Entity Type:Organization
Organization Name:ROSENFELD CHIROPRACTIC CORP
Other - Org Name:ADVANCED HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:IRIS
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:ROSENFELD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:949-380-7215
Mailing Address - Street 1:25255 CABOT RD STE 110
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-5507
Mailing Address - Country:US
Mailing Address - Phone:949-380-7215
Mailing Address - Fax:949-380-7649
Practice Address - Street 1:25255 CABOT RD STE 110
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-5507
Practice Address - Country:US
Practice Address - Phone:949-380-7215
Practice Address - Fax:949-380-7649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-16
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC16040111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC16040Medicare PIN
T18228Medicare UPIN