Provider Demographics
NPI:1891306676
Name:JOHN A. PIRRITANO, PORTOFINO CHIROPRACTIC
Entity Type:Organization
Organization Name:JOHN A. PIRRITANO, PORTOFINO CHIROPRACTIC
Other - Org Name:PORTOFINO CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:PIRRITANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:424-703-5799
Mailing Address - Street 1:601 N AVALON BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:CA
Mailing Address - Zip Code:90744-5871
Mailing Address - Country:US
Mailing Address - Phone:424-703-5799
Mailing Address - Fax:310-861-5920
Practice Address - Street 1:601 N AVALON BLVD STE A
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:CA
Practice Address - Zip Code:90744-5871
Practice Address - Country:US
Practice Address - Phone:310-418-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-13
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty