Provider Demographics
NPI:1811010176
Name:TAFURO, MARC (DC)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:
Last Name:TAFURO
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 1:100 OCEANGATE STE P280
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-4390
Mailing Address - Country:US
Mailing Address - Phone:562-590-7349
Mailing Address - Fax:562-590-7359
Practice Address - Street 1:100 OCEANGATE STE P280
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-4390
Practice Address - Country:US
Practice Address - Phone:562-590-7349
Practice Address - Fax:562-590-7359
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 29678111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor