Provider Demographics
NPI:1790847051
Name:LAUBACH, PATRICK JOHN (DC)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:JOHN
Last Name:LAUBACH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2545 CHINO HILLS PKWY
Mailing Address - Street 2:STE J
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-5109
Mailing Address - Country:US
Mailing Address - Phone:714-777-0888
Mailing Address - Fax:
Practice Address - Street 1:2545 CHINO HILLS PKWY
Practice Address - Street 2:SUITE J
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-5109
Practice Address - Country:US
Practice Address - Phone:909-393-3333
Practice Address - Fax:909-393-4466
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC21034111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor