Provider Demographics
NPI:1942258447
Name:MERINO, ISAAC (DC)
Entity Type:Individual
Prefix:DR
First Name:ISAAC
Middle Name:
Last Name:MERINO
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:PO BOX 120
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90251-0120
Mailing Address - Country:US
Mailing Address - Phone:310-679-7146
Mailing Address - Fax:310-679-7022
Practice Address - Street 1:3940 MARINE AVE
Practice Address - Street 2:SUITE I
Practice Address - City:LAWNDALE
Practice Address - State:CA
Practice Address - Zip Code:90260-2333
Practice Address - Country:US
Practice Address - Phone:310-679-7146
Practice Address - Fax:310-679-7022
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27939111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor