Provider Demographics
NPI:1184871493
Name:CIAMBOTTI-TITIZIAN CHIROPRACTIC, INC
Entity type:Organization
Organization Name:CIAMBOTTI-TITIZIAN CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PHILIP
Authorized Official - Last Name:CIAMBOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:818-752-0366
Mailing Address - Street 1:1620 VICTORY BLVD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-2915
Mailing Address - Country:US
Mailing Address - Phone:818-752-0366
Mailing Address - Fax:818-247-2722
Practice Address - Street 1:1620 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91201-2915
Practice Address - Country:US
Practice Address - Phone:818-752-0366
Practice Address - Fax:818-247-2722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30877111N00000X
CA19732111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty