Provider Demographics
NPI:1245958073
Name:DIEP NEURO SPINE CHIROPRACTIC INSTITUTE, A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:DIEP NEURO SPINE CHIROPRACTIC INSTITUTE, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DIEP
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:626-757-9458
Mailing Address - Street 1:430 S GARFIELD AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-3876
Mailing Address - Country:US
Mailing Address - Phone:626-575-1211
Mailing Address - Fax:626-575-1511
Practice Address - Street 1:430 S GARFIELD AVE STE 101
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3876
Practice Address - Country:US
Practice Address - Phone:626-575-1211
Practice Address - Fax:626-575-1511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-18
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty