Provider Demographics
NPI:1255610069
Name:BECKINGHAM CHIROPRACTIC INC
Entity type:Organization
Organization Name:BECKINGHAM CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:IAN
Authorized Official - Middle Name:INTEUS
Authorized Official - Last Name:BECKINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:310-614-2024
Mailing Address - Street 1:11110 OHIO AVE
Mailing Address - Street 2:108
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-3388
Mailing Address - Country:US
Mailing Address - Phone:310-614-2024
Mailing Address - Fax:310-473-5077
Practice Address - Street 1:11110 OHIO AVE
Practice Address - Street 2:108
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-3388
Practice Address - Country:US
Practice Address - Phone:310-614-2024
Practice Address - Fax:310-473-5077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30933111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty