Provider Demographics
NPI:1255730214
Name:A PINA CHIROPRACTIC CORP
Entity type:Organization
Organization Name:A PINA CHIROPRACTIC CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RODRIGO
Authorized Official - Middle Name:
Authorized Official - Last Name:PINA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:310-792-5490
Mailing Address - Street 1:20112 ANZA AVE
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-2009
Mailing Address - Country:US
Mailing Address - Phone:310-792-5490
Mailing Address - Fax:310-792-5495
Practice Address - Street 1:20112 ANZA AVE
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-2009
Practice Address - Country:US
Practice Address - Phone:310-792-5490
Practice Address - Fax:310-792-5495
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A PINA CHIROPRACTIC CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-08-15
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29192111NR0400X
CADC29273111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
W18456Medicare PIN