Provider Demographics
NPI:1700104585
Name:DR. PRICE CHIROPRACTIC INC
Entity Type:Organization
Organization Name:DR. PRICE CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:DON
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:323-467-5200
Mailing Address - Street 1:5336 FOUNTAIN AVENUE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-1005
Mailing Address - Country:US
Mailing Address - Phone:323-467-5200
Mailing Address - Fax:323-467-1952
Practice Address - Street 1:5336 FOUNTAIN AVENUE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-1005
Practice Address - Country:US
Practice Address - Phone:323-467-5200
Practice Address - Fax:323-467-1952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-04
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC12023111N00000X
CADC15537111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty