Provider Demographics
NPI:1932652054
Name:ITO CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:ITO CHIROPRACTIC CORPORATION
Other - Org Name:DR. BRIAN ITO, D.C.
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:TAKESHI
Authorized Official - Last Name:ITO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:805-653-6008
Mailing Address - Street 1:5700 RALSTON ST
Mailing Address - Street 2:STE. 110
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-6050
Mailing Address - Country:US
Mailing Address - Phone:805-653-6008
Mailing Address - Fax:805-644-6008
Practice Address - Street 1:5700 RALSTON ST
Practice Address - Street 2:STE. 110
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-6050
Practice Address - Country:US
Practice Address - Phone:805-653-6008
Practice Address - Fax:805-644-6008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-25
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30009111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty