Provider Demographics
NPI:1760497143
Name:JOHN BIANCHI INC,A CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:JOHN BIANCHI INC,A CHIROPRACTIC CORPORATION
Other - Org Name:BONES FAMILY CHIROPRACTIC WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:BIANCHI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:626-795-3456
Mailing Address - Street 1:300 S RAYMOND AVE
Mailing Address - Street 2:SUITE 19
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2620
Mailing Address - Country:US
Mailing Address - Phone:626-795-3456
Mailing Address - Fax:
Practice Address - Street 1:300 S RAYMOND AVE
Practice Address - Street 2:SUITE 19
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2620
Practice Address - Country:US
Practice Address - Phone:626-795-3456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26607111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC26607OtherCHIROPRACTIC LIC. NUMBER
CA1952345878OtherINDIVIDUAL NPI NUMBER
CAU83404Medicare UPIN