Provider Demographics
NPI:1760898225
Name:CARAZA-HA CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:CARAZA-HA CHIROPRACTIC CORPORATION
Other - Org Name:ELEMENTS OF WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CARAZA
Authorized Official - Suffix:
Authorized Official - Credentials:DC, LAC
Authorized Official - Phone:949-392-6490
Mailing Address - Street 1:2900 BRISTOL ST STE J102
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-7918
Mailing Address - Country:US
Mailing Address - Phone:949-392-6490
Mailing Address - Fax:949-392-6491
Practice Address - Street 1:2900 BRISTOL ST STE J102
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-7918
Practice Address - Country:US
Practice Address - Phone:949-392-6490
Practice Address - Fax:949-392-6491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-05
Last Update Date:2014-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32374111N00000X
CA28672111N00000X
CA15371171100000X
CA15389171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty