Provider Demographics
NPI:1730493735
Name:DELEON CHIROPRACTIC CENTER, INC
Entity Type:Organization
Organization Name:DELEON CHIROPRACTIC CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:DELEON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:310-274-0022
Mailing Address - Street 1:9150 WILSHIRE BLVD
Mailing Address - Street 2:250
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-3427
Mailing Address - Country:US
Mailing Address - Phone:310-274-0022
Mailing Address - Fax:310-271-9575
Practice Address - Street 1:9150 WILSHIRE BLVD
Practice Address - Street 2:250
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-3427
Practice Address - Country:US
Practice Address - Phone:310-274-0022
Practice Address - Fax:310-271-9575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-02
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24332111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty