Provider Demographics
NPI:1821395856
Name:SUBIA, ANTHONY J III (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:J
Last Name:SUBIA
Suffix:III
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 1:200 N MARYLAND AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-4262
Mailing Address - Country:US
Mailing Address - Phone:818-247-4411
Mailing Address - Fax:
Practice Address - Street 1:200 N MARYLAND AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4262
Practice Address - Country:US
Practice Address - Phone:818-247-4411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC31840111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor