Provider Demographics
NPI:1457343022
Name:PIRRITANO, ANTHONY JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:JOHN
Last Name:PIRRITANO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38830 CALLE DE COMPANERO
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-8877
Mailing Address - Country:US
Mailing Address - Phone:951-677-6299
Mailing Address - Fax:951-737-2820
Practice Address - Street 1:2250 S MAIN ST
Practice Address - Street 2:STE 203
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-2534
Practice Address - Country:US
Practice Address - Phone:951-737-1252
Practice Address - Fax:951-737-2820
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-18
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22125111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU39585Medicare UPIN